Histopathological evaluation of colonic mucosal biopsy specimens in chronic inflammatory bowel disease: diagnostic implications.

Abstract

In a prospective blind evaluation of multiple colonic mucosal biopsy specimens, 45 clinically well defined patients with chronic inflammatory bowel disease (21 Crohn's disease and 24 ulcerative colitis) and 16 control subjects (seven normal subjects and nine patients with diverticular disease) were studied to identify reproducible histopathological features which could distinguish chronic inflammatory bowel disease (CIBD) from non-CIBD and Crohn's disease from ulcerative colitis. Using kappa statistics 16 of 41 histological features were sufficiently reproducible for further stepwise discriminant analysis to differentiate between CIBD and non-CIBD, and between Crohn's disease and ulcerative colitis. Using the combination of three features (an increase of lymphocytes and plasma cells in the lamina propria, the presence of branching of crypts, and neutrophils in the crypt epithelium) we were able to distinguish CIBD from non-CIBD in 89% of the cases with high probability

Inflammatory bowel disease and spondylarthropathy

“…Leirisalo-Repo et al (20) reported the presence of histologic lesions in the colon or ileum in 50% of patients with rheumatoid arthritis (RA) and 28% of "controls." Some of these differences are almost certainly due to subjective interpretation of subtle histologic abnormalities (22); however, the demonstration of a high prevalence of colonic inflammation in SpA and ileocolonic abnormality in RA (19,20,23) cannot be explained on these grounds and requires alternate explanation.…”

Endoscopy and Histopathology

“…Structural epithelial changes include the presence of an irregular surface, sometimes called pseudovillous or villiform surface and a disturbed crypt architecture. [72][73][74] Atypical presentations such as ulcerative colitis with left-sided colitis and peri-appendicular inflammation or caecal patch are occasionally observed. However, the major clinical conditions where endoscopic and histological lesions may not be characteristic include initial onset of the disease, inflammatory diarrhoea in children, patients with liver disease and IBD, patients under treatment and patients presenting with severe, fulminant disease.…”

The Importance of Clinicopathological Features for Differentiation Between Crohn’s Disease and Ulcerative Colitis.

“…Similar findings were also obtained by Seldenrijk, (1991) and Berre et al, (1995) who found that the mean age for UC was 40 years and 39 years respectively, but the opposite was detected for sex predominance as they found that men were affected more often than women. (17,18,19).…”