Eosinophilia – associated basal plasmacytosis: an early and sensitive histologic feature of inflammatory bowel disease

Abstract

Basal plasmacytosis is an early-onset and highly predictive feature of inflammatory bowel disease (IBD), but may have several restrictions in routine histology. Considering evidences about cooperation between eosinophils and plasma cells in IBD pathogenesis, we investigated immunostain of these two cells as a marker of disease. 343 samplings from 83 patients (52 IBD, 31 non-IBD colitis) were evaluated. The sections were stained with monoclonal antibodies against plasma cells (CD138 and MUM1), and eosinophils (CD193). Eosinophilia-associated basal plasmacytosis (EBP) was related with the histologic diagnosis of IBD (90.3% IBD and 35.4% non-IBD colitides, p < 0.005, sensitivity 90.4%). A strong relation was detected between the occurrence of EBP and (i) the achieving of a complete endoscopic mapping; (ii) the presence of other characteristic lesions of IBD in single segmental sampling, although EBP was evident in more than 40% of samples without other IBD-related lesions. EBP is a sensitive histologic feature of IBD, especially at the first endoscopic sampling, even in the absence of the other characteristic histologic lesions, and may help in formulating a more precise diagnosis in this setting.

Histopathology of IBD Colitis. A practical approach from the pathologists of the Italian Group for the study of the gastrointestinal tract (GIPAD)

“…Crypt abscesses are more common in UC (41%) than in CD (19%). The number of eosinophils is variable, but their coexistence with basal plasmocytosis (more than 3 at the base and lateral part of crypts) make a diagnosis of UC more likely, especially at first endoscopic sampling 35 . Moreover, at first diagnosis, a large number of eosinophils (over 60 for 10 HPF), in particular in the left colon, can be predictive of non-reponse to medical therapy 36 , 37 .…”

“…Focal or diffuse basal plasmacytosis is the earliest diagnostic feature with the highest predictive value for diagnosis and can be identified in 38% of patients within 2 weeks after presentation 2 , 4 . The association between basal plasmocytosis and eosinophils raises sensivity for the diagnosis of UC 35 . Strong immunohistochemical expression of TNFα in plasma cells has been recently described in UC patients at early stage disease, with possible implications for treatment approaches 38 .…”

Histological scoring systems in ulcerative colitis patients: a routine practice perspective

“…There generally is consensus and good interobserver agreement regarding evaluation of active disease, represented by neutrophils in crypt epithelium, and formation of crypt abcesses. Elements diagnostic for quiescent disease are absence of neutrophils in lamina propria, though reminiscents of chronic inflammation may still be found, along with eosinophils 6,15 .…”

Pediatric Inflammatory Bowel Disease: A Review of Immune Homeostasis and Genetics with an Emphasis on the IL-10 Pathway

“…Aydemir et al reported significantly higher neutrophil volume distribution width (NVDW) in UC and CD patients compared to normal controls and propose NVDW as an objective parameter for IBD diagnosis [41]. Eosinophilia-associated basal plasmacytosis has been postulated as a sensitive and early histological feature of inflammatory bowel disease [43]. Recently, certain single stranded RNA sequences, 18-24 nucleotides long, known as MicroRNA (MiRNA) [44], have been proposed to be associated with IBD [45] and could potentially be utilized as a diagnostic marker.…”