PMC9553307_01
(A-D) Colonoscopy showed segmental intestinal disease; (E) pathology found inflammatory cell infiltration in intestinal mucosa, epithelioid granuloma in submucosa; (F) chest CT scan showed multiple patchy ground-glass shadows; (G) a total gastrointestinal CT angiography showed segmental leaping thickening in part of colon; (H) a repeat chest CT scan after systemic steroid therapy; (I-L) a repeat colonoscopy after three infliximab treatments.
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In Japan, colonoscopy (October 7, 2020) showed multiple ulcers between the sigmoid colon to the terminal ileum (Figure 1A-D), and pathology found that inflammatory cell infiltration in intestinal mucosa and epithelioid granuloma in submucosa (Figure 1E). A chest high resolution computed tomography (HRCT) was urgently performed and result showed infectious lesions in the upper lobe of the right lung and the lower lobe of both lungs, with multiple patchy ground-glass shadows and nodular ground-glass shadows, which suggested interstitial pneumonia (Figure 1F). A total gastrointestinal CT angiography showed that segmental leaping thickening in part of jejunum, distal ileum, ileocecal, ascending colon and transverse colon, proliferation of peripheral small vessels, multiple enlarged lymph nodes around the diseased intestine and at the root of mesenteric vessels (Figure 1G). A follow-up chest CT after 5 days (December 15, 2020) showed that multiple patellar ground glass shadows were almost completely absorbed under the pleura of the lower lobe of both lungs (Figure 1H). A repeat colonoscopy after 4 months (April 19, 2021) revealed multiple hyperplastic small polyps in the terminal ileum, ascending colon, transverse colon and descending colon, with some scars (Figure 1I-L).