Colitis

Author: Mikael Häggström

Comprehensiveness

On this resource, the following formatting is used for comprehensiveness:

• Minimal depth
• (Moderate depth)
• ((Comprehensive))

Microscopic evaluation

Also look for collagenous colitis, with a thickened subepithelial collagen band that is typically more than 10 μm in thickness.

• Look for signs of active (or acute) and/or chronic colitis:

Signs of active (or acute) colitis:

• Neutrophilic cryptitis
• Neutrophilic crypt abscesses
• Ulceration or granulation tissue
• Ischemic changes (including superficial necrosis, hemorrhage, crypt shrinkage/dropout, fibrin thrombi)

Signs of chronic colitis:

• Abnormal crypt orientation a
• Abnormal crypt branching
• Paneth cell or gastric metaplasia (only apllies in the left colon and rectum)
• Elevation of crypts relative to the muscularis mucosa

(Consider the clinical and/or endoscopic finding in the evaluation.)

Further workup of colitis

Distinguish:

• Distribution: Patchy versus diffuse
• Severity: Mild, moderate or severe
• Presence of crypt regeneration, granuloma, inflammatory pseudomembranes, parasites, viral inclusions or epithelial dysplasia.

Microscopy report

Example of a normal sample, when colitis was suspected in the referral:

( Optionally: Colonic/Rectal mucosa without significant histopathologic changes.) Negative for acute and chronic colitis.

Example of findings of both active and chronic colitis:

(Ascending, transverse, descending, and sigmoid colon, biopsies:) Mild chronic active colitis, with associated cryptitis and crypt abscesses. (Negative for ulceration, granulomata and dysplasia.)

Main page

• Main page of Patholines