Isolated Pulse Granuloma in a Mesenteric Lymph Node: Unusual Nodal Manifestation Associated With Crohn Disease Complicated by Ileal Adenocarcinoma

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Pulse granuloma is an unusual inflammatory reaction to legumes. Pulse granulomas of the gastrointestinal tract are typically accompanied by significant mural damage due to ulceration, fistula, or perforation. We describe a solitary pulse granuloma in a mesenteric lymph node of a 74-year-old male patient with Crohn disease, who presented with an ileal adenocarcinoma, but without demonstrable fistula or perforation. To our knowledge, this is only the second reported example of Crohn disease associated with a pulse granuloma in a mesenteric node and also only the second example of a nodal location for any documented pulse granuloma. We postulate that mesenteric lymph node pulse granuloma may represent a unique and unusual type of morphology associated with Crohn disease.

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