Abstract
Objective To explore the valuable indicators for differential diagnosis by comparing the clinical features of Crohn′s disease (CD) with primary intestinal lymphoma (PIL). Methods From 2010 to 2017, at The Seventh Medical Center of PLA General Hospital, a total of 91 patients diagnosed with CD or PIL were enrolled, including 76 cases of CD, 14 cases of PIL and one case of CD with secondary lymphoma. The clinical data of enrolled patients were retrospectively analyzed. T-test, non-parametric test and chi-square test were used for statistical analysis. Results The average age at diagnosis of CD patients was (37.7±16.0) years, which was younger than that of PIL patients (52.6±19.6) years, and the difference was statistically significant (t=-3.085, P=0.003). The median duration of CD was 36.0 months, which was longer than that of PIL (3.5 months), and the difference was statistically significant (Z=-3.616, P<0.01). Abdominal pain and extra-intestinal manifestations (oral ulcers, joint injuries, erythema nodosum and perianal lesions) were more common in CD patients, and the differences were all statistically significant (χ2=9.427 and 5.173, both P<0.05). CD patients were not diagnosed by colonoscopic biopsy alone. Totally 13 of 14 patients were diagnosed by colonoscopic biopsy and immunohistochemisty and one patient was diagnosed after surgery. The diagnostic rate of pathological biopsy in PIL group was significantly higher than that in CD group (χ2=82.584, P<0.01). One patient was initially clinically diagnosed as CD, and then developed secondary lymphoma after five times of infliximab treatment. Conclusions The diagnosis of CD is generally supported by young age, long course of disease, abdominal pain and extra-intestinal manifestations. The diagnostic rate of colonoscopic biospsy in PIL patients is higher than that in CD patients. Key words: Crohn′s disease; Diagnosis, differential; Primary intestinal lymphoma; Clinical features
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