Reviewer ’s report  
 
Title: Microscopic features of small bowel mucosa of patients with Crohn ’s disease  
 
Version: 0 Date: 12 Aug 2019  
 
Reviewer: Arvind Ahuja  
 
Reviewer's report:  
 
Yun et al have evaluated 22 microscopic features of Crohns disease in 137 patients of CD, 20 
patients of suspected  Crohns disease and 96 patients of Non Crohns disease. Although most of 
the microscopic studied by them are classical features; however they have also studied 
granulomatous lymphangitis and lymphangiectasia. They have concluded that specificity and 
sensiti vity, granulomatous lymphangitis  is superior to non -caseating epithelioid granuloma.  
They have tried to validate the hypothesis proposed by Van Kruiningen's that granulomatous 
lymphangitis plays important role in the pathogenesis of Crohns disease.  
 
The ma nuscript is quite interesting. I have following comments/queries for authors - 
 
1. Van Kruiningen's have shown granulomatous lymphangitis in 53% of resection specimens out 
of 34 cases studied. In the present study granulomatous lymphangitis was present in approx 24% 
of biopsies with Crohns disease. However, further large studies on resection specimens are 
required to validate this finding.  
 
 
2. Granulomatous lymphangitis may be a non specific finding and it is likely to be present in 
infection related ileit is; however again it needs to be studied in large cohort.  
 
 
3. In a review by Kedia et al concluded that micogranuloma are important histological features  
in CD but in tuberculosis endemic regions the diagnosis of Crohns disease is always clinic - 
pathologi cal, endoscopic and radiological.  
 
 
4. The IHC pictures are not clear and I am not able to see the positive reaction (Fig 2D,E).  
 
 
5. Authors should include important clinical and endoscopic findings based on which they 
diagnosed CD in 137 patients.  
 
 
6. It wi ll be interesting to know in how many patients lymphadenopathy was seen out of 24 
patients with granuloma.  
 
Wish you all the best!  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in th e manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisati on that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscrip t, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents  relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no co mpeting interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interest.  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Acc ess Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understa nd that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editor s, which will not be published.  
 
I agree to the open peer review policy of the journal  
 
Reviewer ’s report  
 
Title: Microscopic features of small bowel mucosa of patients with Crohn ’s disease  
 
Version: 0 Date: 12 Aug 2019  
 
Reviewer: Arvind Ahuja  
 
Reviewer's report:  
 
Yun et al have evaluated 22 microscopic features of Crohns disease in 137 patients of CD, 20 
patients of suspected  Crohns disease and 96 patients of Non Crohns disease. Although most of 
the microscopic studied by them are classical features; however they have also studied 
granulomatous lymphangitis and lymphangiectasia. They have concluded that specificity and 
sensiti vity, granulomatous lymphangitis  is superior to non -caseating epithelioid granuloma.  
They have tried to validate the hypothesis proposed by Van Kruiningen's that granulomatous 
lymphangitis plays important role in the pathogenesis of Crohns disease.  
 
The ma nuscript is quite interesting. I have following comments/queries for authors - 
 
1. Van Kruiningen's have shown granulomatous lymphangitis in 53% of resection specimens out 
of 34 cases studied. In the present study granulomatous lymphangitis was present in approx 24% 
of biopsies with Crohns disease. However, further large studies on resection specimens are 
required to validate this finding.  
 
 
2. Granulomatous lymphangitis may be a non specific finding and it is likely to be present in 
infection related ileit is; however again it needs to be studied in large cohort.  
 
 
3. In a review by Kedia et al concluded that micogranuloma are important histological features  
in CD but in tuberculosis endemic regions the diagnosis of Crohns disease is always clinic - 
pathologi cal, endoscopic and radiological.  
 
 
4. The IHC pictures are not clear and I am not able to see the positive reaction (Fig 2D,E).  
 
 
5. Authors should include important clinical and endoscopic findings based on which they 
diagnosed CD in 137 patients.  
 
 
6. It wi ll be interesting to know in how many patients lymphadenopathy was seen out of 24 
patients with granuloma.  
 
Wish you all the best!  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in th e manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisati on that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscrip t, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents  relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no co mpeting interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interest.  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Acc ess Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understa nd that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editor s, which will not be published.  
 
I agree to the open peer review policy of the journal  
 
Please review this paper.
user
Reviewer ’s report  
 
Title: Microscopic features of small bowel mucosa of patients with Crohn ’s disease  
 
Version: 0 Date: 12 Aug 2019  
 
Reviewer: Arvind Ahuja  
 
Reviewer's report:  
 
Yun et al have evaluated 22 microscopic features of Crohns disease in 137 patients of CD, 20 
patients of suspected  Crohns disease and 96 patients of Non Crohns disease. Although most of 
the microscopic studied by them are classical features; however they have also studied 
granulomatous lymphangitis and lymphangiectasia. They have concluded that specificity and 
sensiti vity, granulomatous lymphangitis  is superior to non -caseating epithelioid granuloma.  
They have tried to validate the hypothesis proposed by Van Kruiningen's that granulomatous 
lymphangitis plays important role in the pathogenesis of Crohns disease.  
 
The ma nuscript is quite interesting. I have following comments/queries for authors - 
 
1. Van Kruiningen's have shown granulomatous lymphangitis in 53% of resection specimens out 
of 34 cases studied. In the present study granulomatous lymphangitis was present in approx 24% 
of biopsies with Crohns disease. However, further large studies on resection specimens are 
required to validate this finding.  
 
 
2. Granulomatous lymphangitis may be a non specific finding and it is likely to be present in 
infection related ileit is; however again it needs to be studied in large cohort.  
 
 
3. In a review by Kedia et al concluded that micogranuloma are important histological features  
in CD but in tuberculosis endemic regions the diagnosis of Crohns disease is always clinic - 
pathologi cal, endoscopic and radiological.  
 
 
4. The IHC pictures are not clear and I am not able to see the positive reaction (Fig 2D,E).  
 
 
5. Authors should include important clinical and endoscopic findings based on which they 
diagnosed CD in 137 patients.  
 
 
6. It wi ll be interesting to know in how many patients lymphadenopathy was seen out of 24 
patients with granuloma.  
 
Wish you all the best!  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in th e manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I recommend additional statistical review  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisati on that may in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscrip t, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents  relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
If you can answer no to all of the above, write 'I declare that I have no co mpeting interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interest.  
 
I agree to the open peer review policy of the journal. I understan d that my name will be included 
on my report to the authors and, if the manuscript is accepted f or publication, my named report 
including any attachments I upload will be posted on the website along with the authors' 
responses. I agree for my report to be made available under an Open Acc ess Creative Commons 
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understa nd that any comments 
which I do not wish to be included in my named report can be in cluded as confidential comments 
to the editor s, which will not be published.  
 
I agree to the open peer review policy of the journal  
 
assistant