Pyloric Gland Metaplasia of the Ileocecal Valve: Clinicopathologic Correlates of Inflammatory Bowel Disease

Pyloric gland metaplasia of the ileocecal valve, in the setting of Crohn’s disease, is an unusual clinical entity. Though its etiology and pathogenesis remains unclear, metaplastic changes have been associated with chronic inflammation and inflammatory bowel disease. Herein, we report a case of a 23-year-old male who presented for surveillance colonoscopy after being diagnosed with Crohn's disease four years ago. Diagnostic colonoscopy revealed stenosis of the ileocecal valve as well as a 5 mm polypoid circumferential non-obstructing lesion. Excisional biopsy followed by histopathology revealed pyloric metaplasia and non-necrotizing epithelioid cell granuloma. We discuss the clinical significance of pyloric gland metaplasia of the ileocecal valve in the context of inflammatory bowel disease.