Bamboo joint-like appearance of the stomach: a histopathological study

A bamboo joint-like (BJL) appearance is an endoscopic finding characterized by swollen longitudinal folds transversed by erosive fissures or linear fu rrows, and it seems to be associated with Crohn's disease (CD). We performe d gastroduodenoscopy in 1781 patients, and found BJL lesions in 15 (65.2%) of 23 CD patients and 20 (1.1%) of 1758 non-CD patients. Histological exami nation of the biopsy specimens showed sharp, fissure-like erosion or mucosa l cleft in 7 (50%) out of 14 CD patients and one (20%) out of 5 non-CD pati ents. All cases with fissure-like erosion or, mucosal cleft revealed lympho id aggregates, eosinophilic infiltration and edema in the superficial porti on of the surrounding lamina propria. Epithelioid granuloma was seen at the base of the fissure-like erosion in two cases with CD. Our results indicat ed that fissure-like erosion or mucosal cleft in gastric biopsy specimens r eflects the BJL appearance, and that such findings may provide a diagnostic clue to CD.