case_images: PMC10602771_01
case_images: Imaging and pathological findings of the patient. (A) Typical longitudinal ulcer in transanal small bowel microscopy. (B) Representative CT scan of the chest showing a mass-like abnormal density shadow in the anterior segment of the upper lobe of the right lung. (C) Chest CT scan of a mass measuring approximately 3.6 cm x 3.0 cm in the anterior segment of the upper lobe of the right lung with unrefined margins. (D) Lung puncture biopsy specimen shows epithelioid histiocytes, fibroblast proliferation, a small amount of lymphocytic infiltration, and multinucleated giant cells and non-necrotic epithelioid granuloma.
case_images: fmed-10-1187208-g001.jpg
case_images: PMC10602771_01_fmed-10-1187208-g001.jpg
case_images: fig1
case_images: Enteroscopy showed that there were several longitudinal depressions with a length of about 4 cm-10 cm in the ileum about 2 m and 1.8 m away from the ileocecal valve and at the end of the ileum, surrounded by paving stones (Figure 1A). Computed tomography (CT) of the lungs revealed nodular and mass-like abnormal density shadows (Figure 1B), the largest was located in the anterior segment of the upper right lobe and measured 3.6 x 3.0 cm, with unrefined margins (Figure 1C). Combining the clinical and special staining findings, we diagnosed the lesion of the lung as granulomatous inflammation (Figure 1D). The special staining results are shown in Supplementary Figure S1.
case_images: Imaging and pathological findings of the patient at the time of return visit. (A,B) After 6 months of treatment, a repeat chest CT showed significant improvement of the original lung lesion. (C,D) CT scan of the chest at follow-up until May 2022, with only a few fibrous lesions remaining from the original lung lesion.
case_images: fmed-10-1187208-g002.jpg
case_images: PMC10602771_01_fmed-10-1187208-g002.jpg
case_images: fig2
case_images: CT scans 6 months after discharge showed significant improvement of the pulmonary lesions (Figures 2A,B), indicating that these were associated with CD. The patient's pulmonary lesions remained asymptomatic, and a lung CT in May 2022 suggested focal fibrosis (Figures 2C,D).