Microscopic Colitis: a Clinical and Pathological Review

Fraser, Alan G.; Warren, Bryan F.; Chandrapala, R; Jewell, D P

doi:10.1080/003655202761020489

Cited by 72 publications

(45 citation statements)

References 35 publications

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“…In agreement with previous studies, elevated CRP and erythrocyte sedimentation rate values were more common in MC than in controls, suggesting that, in some cases of MC, the mucosal inflammation may manifest at the systemic level (33,36). However, as our control series was inhomogeneous and not composed of healthy subjects, a comparison with a healthy population might bring out some additional differences in the parameters studied here.…”

Section: Discussionsupporting

confidence: 91%

Clinical characteristics of collagenous and lymphocytic colitis

Koskela

Niemelä

Karttunen

et al. 2004

Scandinavian Journal of Gastroenterology

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Section: Discussionsupporting

confidence: 91%

Clinical characteristics of collagenous and lymphocytic colitis

Koskela

Niemelä

Karttunen

et al. 2004

Scandinavian Journal of Gastroenterology

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“…The mean number of surface epithelial lymphocytes per 100 epithelial cells was 12, which is significantly higher than in idiopathic inflammatory bowel disease, acute colitis, and normal colonic mucosa epithelium, 11,15 but lower than the diagnostic criterion for LC. 4 ). A subepithelial collagen band was not present in any of the cases.…”

Section: Histology Resultsmentioning

confidence: 99%

“…3 Many times patients with prolonged and unresolved diarrhea and nonspecific histologic changes are misdiagnosed as having irritable bowel syndrome 1,3 or ''minimal colitis.'' 4 Clinically, the distinction between these 2 groups of patients has implications for their counseling and clinical management. On purely pathologic grounds, the characterization of those specific histomorphologic and immunohistologic features associated with chronicity would increase the biological understanding and the diagnostic accuracy of the disease.…”

mentioning

confidence: 99%

“…Patients with MC have persistent, watery, bloodless diarrhea, a normal colonoscopy, and chronic inflammation with other specific histologic changes. 4,5 Microscopic colitis comprises 2 entities, namely collagenous colitis (CC) and lymphocytic colitis (LC), which are indistinguishable clinically but are separated by histopathologic characteristics. [4][5][6] Collagenous colitis is characterized by the presence of a subepithelial collagen band (10 mm or more) adjacent to basal membrane, [4][5][6] whereas LC biopsies show more than 20 surface epithelial lymphocytes per 100 epithelial cells.…”

mentioning

confidence: 99%

“…4,5 Microscopic colitis comprises 2 entities, namely collagenous colitis (CC) and lymphocytic colitis (LC), which are indistinguishable clinically but are separated by histopathologic characteristics. [4][5][6] Collagenous colitis is characterized by the presence of a subepithelial collagen band (10 mm or more) adjacent to basal membrane, [4][5][6] whereas LC biopsies show more than 20 surface epithelial lymphocytes per 100 epithelial cells. [4][5][6] In addition, many atypical histopathologic forms of MC and LC have been described, 7,8 such as MC not otherwise specified, 9,10 MC with giant cells, 9 and paucicellular, 10 borderline, 11 and cryptal LC, 12 all of which show more subtle histomorphologic changes than classical MC or LC.…”

mentioning

confidence: 99%

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Lymphocytic Follicles and Aggregates Are a Determinant of Mucosal Damage and Duration of Diarrhea

Shah¹,

Thakkar²,

Shen³

et al. 2013

Archives of Pathology & Laboratory Medicine

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N Context.-Nonspecific changes (nonspecific chronic inflammation) in patients with chronic diarrhea represent the commonest diagnosis in colorectal biopsy interpretation, but these changes are of little clinical significance.Objective.-To find, within this group, histologic and immunohistologic diagnostic criteria to predict the duration and resolution of diarrhea.Design.-Detailed clinical features and histologic findings were analyzed in a cohort of 47 patients with chronic diarrhea, with near-normal histology and no clear-cut known etiologic agent. Immunohistochemistry to mast cells (CD117) and Treg cells (FOXP3) was also assessed in 39 patients.Results.-Increased number of lymphoid follicles and aggregates, increased number of mast cells, and paucity of Treg were the statistically significant key findings (P = .003, P = .008, and P = .04, respectively). The duration of diarrhea was correlated with the number of large lymphoid follicles and aggregates (P = .001, r = .48), number of total lymphoid follicles and aggregates (P = .003, r = .43), density of lymphoid follicles and aggregates (P = .009, r = .38), and total lymphoid follicles and aggregates per biopsy (P = .004, r = .42) and the number of mast cells (P = .001, r = .52). The number of mast cells and Treg cells showed significant difference between resolved and unresolved cases (P = .001 and P = .01 respectively).Conclusions.-Lymphocytic follicles and aggregates colitis, previously regarded as of negligible diagnostic significance, allows the prediction of the behavior of chronic diarrhea in a subset of patients with nonspecific changes on colonic biopsy. The increased number of mast cells and paucity of Treg cells further helps to identify such unresolved cases.

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