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Isolated Pulse Granuloma in a Mesenteric Lymph Node

Unusual Nodal Manifestation Associated With Crohn Disease Complicated by Ileal Adenocarcinoma

Medlicott, Shaun A. C., MD, FRCPC; Eidus, Leslie, MD, FRCPC; Trpkov, Kiril, MD, FRCPC

doi: 10.1097/PCR.0000000000000273
Case Reports

Pulse granuloma is an unusual inflammatory reaction to legumes. Pulse granulomas of the gastrointestinal tract are typically accompanied by significant mural damage due to ulceration, fistula, or perforation. We describe a solitary pulse granuloma in a mesenteric lymph node of a 74-year-old male patient with Crohn disease, who presented with an ileal adenocarcinoma, but without demonstrable fistula or perforation. To our knowledge, this is only the second reported example of Crohn disease associated with a pulse granuloma in a mesenteric node and also only the second example of a nodal location for any documented pulse granuloma. We postulate that mesenteric lymph node pulse granuloma may represent a unique and unusual type of morphology associated with Crohn disease.

From the Department of Pathology and Laboratory Medicine, Rockyview General Hospital, Calgary Laboratory Services and University of Calgary, Calgary, Alberta, Canada.

Reprints: Kiril Trpkov, MD, FRCPC, Department of Pathology and Laboratory Medicine, Calgary Laboratory Services and University of Calgary, Rockyview General Hospital, 7007 14 St, Calgary, Alberta, Canada T2V 1P9. E-mail: kiril.trpkov@cls.ab.ca.

The authors have no funding or conflicts to declare.

© 2018 Lippincott Williams & Wilkins, Inc.