Table 1 What the early pathologists really said
YearCasesDescription
1939 Blackburn822“The lymphatic channels show generalised dilatation and are closely packed with lymphocytes…”
“Lymphadenoid hyperplasia…gives rise to lymphatic obstruction and edema, which in turn cause ulceration and non-specific infection.”
1948 Warren9120“The lymphatics are obstructed by lymphocytes. In our series lymphatic blockade also was observed, but was the result of endothelial proliferation and desquamation.”
“Microscopic sequences indicate that swelling and proliferation of lymphatic endothelium in intestine and lymph nodes causes occlusion of lymphatics and resulting edema.”
1952 Van Patter10377“The lymphatics of the submucosa, in addition to dilatation, possessed certain noteworthy features. Here focal areas of endothelial proliferation occurred, as originally described by Warren. The lumina of these lymph vessels often contained numerous lymphocytes and a number of histiocytes.”
“The intraluminal cellular accumulations of lymphocytes appeared to result from the sieve-like action of these vessels which permitted the retention of the cellular component of the lymph while allowing the fluid content to escape into the tissue spaces. The histiocytes appeared to have their origin from the proliferating endothelial foci in the lymphatics…”
1963 Meadows1129“The major finding…is a pronounced edema of the entire bowel wall, but especially marked in the submucosa.” “…accompanied by lymphangiectasis.”
“In the submucosa…and, most prominently, hypertrophy and hyperplasia of lymphoid follicles and aggregates.”
1964 Lockhart-Mummery1275“The inflammation in Crohn’s disease consists of focal collections of lymphocytes, often with prominent follicle formation, scattered through all layers of the bowel wall including the serosa. These foci usually lie alongside an artery or vein and may be even more closely related to lymphatic channels.”
1971 Mottet13“A characteristic microscopic lesion of regional enteritis (referring to his Figure 1-1) consisting of a loose patch of histiocytes and often including giant histiocytes surrounded by small mononuclear cells, principally lymphocytes and plasma cells. This lesion is located, as commonly seen, adjacent to a distended lymphatic that is perivascular.”
1972 Morson14“Foci of lymphocytes, some with germinal centers, scattered throughout the mucosa, submucosa, and serosa, are probably the only microscopic feature of Crohn’s disease present in all patients. In the submucosa and serosa these foci appear to be intimately related to vascular channels, probably lymphatics.”
“It is well known that the granulomas have a close histological relationship to lymphatic channels.”