Lymphoid hyperplasia of the lower gastrointestinal tract in inflammatory bowel disease. The role of the red ring sign

Background and aims: Clinical observations suggest that the initial inflammation in inflammatory bowel disease (IBD), especially in Crohn's disease (CD), might take place in the lymphoid follicle (LF) surrounded by red ring sign (RRS). The present study was performed to analyse the role of the LFs in patients with IBD compared to healthy controls. Methods: 146 consecutive patients (84 male, 62 female; median age 34.4 years, range 19–55 years) were enrolled in this prospective study when undergoing elective colonoscopy. The standardized pictures from the terminal ileum throughout the colon were taken using magnif…