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Background To compare the clinical characteristics of Crohn’s disease (CD) and primary intestinal lymphoma (PIL), to find out valuable, relevant indicators for differential diagnosis. Methods The clinical, endoscopic and pathological data of 67 cases (54 cases of Crohn’s disease and 13 cases of primary intestinal lymphoma) admitted by the PLA Army General Hospital in the last seven years were analysed retrospectively. Results The average age of CD was lower than that of PIL, but the course of CD was longer than that of PIL (p Abdominal pain, oral ulcers, perianal lesions, history of surgery (appendectomy or intestinal resection), and multi-site lesions were more common in CD than in PIL (p The biopsy diagnosis rate of PIL was 92.3%, while 85.1% of CD’s pathological manifestations were non-specific inflammation. So the biopsy diagnosis rate of PIL was significantly higher than that of CD (p Two patients were initially diagnosed with CD based on the clinical comprehensive analysis. The clinical symptoms disappeared, and the colonoscopy achieved mucosal healing after treatment. But the patients‘ symptoms repeated, and they were eventually diagnosed as PIL. Conclusions The clinical and endoscopic characteristics of Crohn’s disease (CD) and primary intestinal lymphoma (PIL) are similar, but they have their own characteristics. Therefore, the differential diagnosis is difficult. The diagnosis of CD is more supported by young, long course of the disease, abdominal pain, oral ulcers, perianal lesions, history of surgery (appendectomy, resection), and multi-site lesions. Short disease duration, abdominal mass and single-site lesion are more common in PIL. Biopsy diagnosis rate of PIL is higher than that of CD. In the case of the diagnosis of PIL after CD treatment, misdiagnosis, a combination of the two and drug induction should be considered.

Background To evaluate the efficacy and safety of Infliximab (IFX) in the management of refractory ulcerative colitis (UC) and UC with extra-intestinal manifestations. Methods The clinical data for 36 cases including refractory UC patients and UC patients with special extra-intestinal manifestations, who all accepted treatment with IFX, were analysed retrospectively. Results Among all the 36 cases, 33 were refractory UC (5 with extra-intestinal manifestations) and another 3 with special extra-intestinal manifestations (2 with perianal abscess and 1 with ankylosing spondylitis). After treatment with IFX, 13 patients achieved clinical remission, of whom 3 achieved mucosal healing, 15 achieved clinical response and 8 failed to respond. The total effective rate of IFX treatment was 77.78%, remission rate 36.11%; Among 8 cases with extra-intestinal manifestations, 5 patients‘ extra-intestinal manifestations improved and the efficacy rate was 62.5%. No serious adverse events occurred during observation. Conclusions IFX is effective and safe in the management of refractory UC and extra-intestinal manifestations.

Background To explore the clinical features, endoscope expression, pathology features, gene test results, diagnosis, treatment and prognosis of Peutz-Jeghers’syndrome (PJS). Methods Retrospective analyses were performed on the clinical data of 46 cases of PJS patients in Department of Gastroenterology, PLA Army General Hospital from 2007 to 2017. Results All 46 patients had mucocutaneous melanin pigmentation and multiple gastrointestinal polyposis. The pigmentation was first noticed often within 5 y, and 14 cases had a family history. The clinical manifestations were mainly black spots, abdominal pain, hematochezia and anaemia. Histological examinations showed that 20 patients were classified as hamartomatous polyps, 18 as adenomatous polyps, 14 as inflammatory polyps and 10 as zigzag polyps. The results of 11 patients sequenced a panel of 20 genes previously associated with CRC by next-generation sequencing showed 5 cases with gene mutations, and three of which with intussusception and surgical histories were found to have pathogenic germline mutations in the STK11 gene. Endoscopic treatment is the main therapy, but endoscopy combined with laparoscopy or surgical treatment should be available when complications occur, or the polyp is too large. A few patients found malignant tumours during follow-up. Conclusions PJS is a hereditary disease which is characterised by spots of the skin or mucosa and gastrointestinal multiple polyps. The main pathological features were hamartoma and adenoma. The risk of intussusception and surgical operation is found to be high in the patients with pathogenic germline mutations in the STK11 gene, but the sample size was too small and needs to be further expanded. Endoscopic treatment is the main therapy. PJS patients should follow-up regularly due to the increased risk of cancer and being easy to relapse.