Cobblestone appearance (hollow viscera)

Cobblestoning (having a cobblestone appearance) can occur in a number of hollow organs with mucosa, most commonly the bowel, in the setting of Crohn disease.
Longitudinal and circumferential fissures and ulcers separate islands of mucosa, giving it an appearance reminiscent of cobblestones.
Cobblestone appearance has been reported in:
- Crohn disease: small and large bowel
- candida esophagitis
- Hirschsprung disease
- eosinophilic gastritis
- duodenitis
- Brunner gland hyperplasia of the duodenum
- nodular lymphoid hyperplasia in duodenal cap
Other disease processes can present with cobblestone-like imaging characteristics.
- intraluminal adhesions of the fallopian tubes on hysterosalpingography
- cobblestone lissencephaly (in the brain)
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