Collagenous Colitis: A Clinicopathological Review

Bogomoletz, W. V.

doi:10.1159/000171049

Cited by 36 publications

(7 citation statements)

References 7 publications

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“…Therefore, the diagnosis of this condition depends on the histological identification of the characteristic subepithelial collagenous bands accompanied by a largely detached surface epithelium and a slight to moderate inflammatory infiltrate within an otherwise grossly normal mucosa. Sometimes, the subepithelial collagen thickening is only focal, and the bands might not be pronounced enough to fulfill the classical diagnostic criterium of over 10-µm thickness in well-orientated sections [6,10]. Furthermore, sequential biopsies of the whole colon are required, because sigmoid colon and rectum often fail to show a significantly thickened subepithelial collagenous plate [10,15].…”

Section: Introductionmentioning

confidence: 99%

Tenascin: a sensitive and specific diagnostic marker of minimal collagenous colitis

et al. 2001

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Collagenous colitis is a rare cause of chronic watery diarrhea. In this condition, endoscopic findings are usually normal. Currently, the diagnosis relies on the histological presence of thick subepithelial bands of collagen deposits and an inflammatory infiltrate within the mucosa. However, these subepithelial bands may be developed only focally and may be too subtle to allow a definitive diagnosis upon routine hematoxylin and eosin (HE) and van Gieson's stainings. Recently, we and others were able to show a prominent staining of tenascin and type-VI collagen in the subepithelial band-like structures. In this study, we tested the diagnostic value of tenascin staining and type-VI collagen immunolocalization for the identification of collagenous colitis and compared it with conventional histology and histochemical detection of collagens. The analysis was based on 434 biopsy specimens of collagenous colitis, other forms of colitis, and normal mucosa. We were able to show that the immunohistochemical detection of increased amounts of tenascin, selectively in the subepithelial zone, is a specific test for collagenous colitis, with a sensitivity superior to conventional histological and histochemical detection, especially in minimal collagenous colitis (P<0.001). Of note, tenascin staining also allows the diagnosis of collagenous colitis in biopsies obtained only from the rectum and sigmoid colon, thus avoiding the need for colonoscopic investigations. Tenascin immunostaining is a simple and safe tool to complement conventional histological diagnostics in clinically and histopathologically unclear cases of diarrhea.

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Section: Introductionmentioning

confidence: 99%

Tenascin: a sensitive and specific diagnostic marker of minimal collagenous colitis

et al. 2001

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“…Bogomoletz (~) Laboratoire d'Anatomie Pathologique, Institut Jean Godinot, BP171, F-51056 Reims, France lished his now classical paper, there was an abstract published in Canada, which briefly recorded two patients with apparently similar clinical and histological findings [20]. Between 1980 and 1982, 14 additional cases of collagenous colitis, involving all segments of the colon, were reported from different countries; for review see [4]. The collagenous nature of the deposit was confirmed by histochemistry, electron microscopy and immunofluorescence.…”

Section: The Golden Years (1976-1985)mentioning

confidence: 99%

“…However, the cause and mechanism responsible for the formation of the subepithelial collagen band-like deposit remain obscure. It is generally assumed that the accumulation of collagen results from abnormal synthesis by the fibroblasts of the colonic pericryptal sheath [4,25]. An inflammatory or toxic injury of undetermined nature could be the starting point.…”

Section: Aetiology and Pathogenesismentioning

confidence: 99%

Collagenous, microscopic and lymphocytic colitis. An evolving concept

Bogomoletz

1994

Vichows Archiv A Pathol Anat

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Collagenous colitis and lymphocytic colitis (previously described as microscopic colitis) are two newly recognised forms of colitis. Both have generated much controversy and continue to do so; their aetiology and pathogenesis are unresolved and their association with a variety of immune-related disorders is intriguing. Response to available therapeutic modalities is often disappointing. The possible relationship or overlap between these two conditions remains a controversial issue. The aim of this review is essentially to present an overview of collagenous colitis and lymphocytic colitis and to propose an unifying concept with an adapted terminology.

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“…Recent reports have also provided immuno histochemical evidence thm some of the trapped fusiform and/or ste llace cells within the deposits are m yo id cells, being positive with antibodies against smooth muscle cell alphc1-ac tin (62). In others, immunofluorescent studies have fa iled to identify immunoglobulins, complement, albumin o r fibrinogen (65), suggest ing that some compo ne nts of this lesio n may vary from patient to patient. Finally, immunoflu1)resccnt methods have also sho wn inc reased deposition of collagen types l and Ill, as well as fibronectin (40,65).…”

mentioning

confidence: 99%

“…In others, immunofluorescent studies have fa iled to identify immunoglobulins, complement, albumin o r fibrinogen (65), suggest ing that some compo ne nts of this lesio n may vary from patient to patient. Finally, immunoflu1)resccnt methods have also sho wn inc reased deposition of collagen types l and Ill, as well as fibronectin (40,65).…”

mentioning

confidence: 99%