Why Haven Large Numbers of MAP Organisms Already Been Found in the Mesentery—in the Lymph Nodes?
One place in the mesentery has been investigated for MAP: the lymph nodes. The earliest descriptions of Crohn’s disease carefully noted that the lymph nodes in the mesentery are often enlarged and, irrespective of their size, often contain the same type of giant cell granulomas found in the bowel wall [90],[91]. The mesenteric lymph nodes from Crohn’s patients were in the early days carefully examined for Mycobacterium tuberculosis, not MAP, and the lack of identification of M. tuberculosis in the Crohn’s nodes was one of the characteristics that distinguished Crohn’s disease from ileocecal tuberculosis. As detailed by Chiodini, attempts were made to culture mycobacteria other than tuberculosis from Crohn’s tissues, including mesenteric lymph nodes, beginning in the late 1970s [92]. In the modern era, a single mesenteric lymph node has been investigated for the presence of, and found to contain, MAP [93]. Why then haven’t large numbers of MAP been found in the mesenteric lymph nodes of
