LAUSR

tectural abnormalities and epithelioid granulomas are common features while granuloma is a very specific indicator. Crohn’s disease can be present anywhere in the gastrointestinal tract but the most common location is the ileocecal region.1,2 Moreover, the diagnosis of gastric Crohn’s, which has an incidence of 10% of cases, is almost always obtained later, during staging of an already diagnosed ileal Crohn’s disease. The histological diagnosis of Crohn’s disease on gastric samples is suggested by the presence of 1) a focal distribution; 2) chronic active inflammatory lesions; 3) the absence of the Helicobacter Pylori (HP) organism; and 4) granuloma. Therefore, gastric Crohn’s disease can be difficult to diagnose because the symptoms can mimic many other conditions and no specific laboratory test is available. The great importance of an interdisciplinary approach between the gastroenterologist and the pathologist in the inflammatory bowel disease field is the main message that emerges from this case report, as well as the need to search for focal structural alterations (vessel abnormalities) in the absence of HP infection and make an accurate morphological evaluation.3,4 These focal stromal abnormalities could be a new diagnostic morphologic pattern in gastric Crohn’s disease, sharing the same value as focal cryptal architectural abnormalities in intestinal involvement. Since the majority of patients with Crohn’s disease lack significant symptoms, the true incidence of the disease depends on whether such pictures are sought for and identified.5