Inflammatory Bowel Disease: Anatomical and Histopathological Study (original) (raw)
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Recent advances in pathobiology and histopathological diagnosis of inflammatory bowel disease
In order to make a diagnosis of ulcerative colitis (UC) or Crohn's disease (CD) which belongs to inflammatory bowel disease (IBD), it is important to evaluate pathologic material in conjunction with clinical, laboratory and endoscopic findings. There are several exceptions to the classical principles of IBD that may lead to diagnostic confusion. UC and CD have a variety of characteristic but also non-specific pathologic features. There are several exceptions to the classical principles of IBD that may lead to diagnostic confusion. This short review summarizes current diagnostic problems and advances with regard to histopathological findings of inflammation and dysplasia in biopsy specimens from UC and CD patients. Keywords: IBD, ulcerative colitis, crohn's disease, pathobiology, histopathology, differential diagnosis
The histopathological approach to inflammatory bowel disease: a practice guide
Virchows Archiv, 2014
Inflammatory bowel diseases (IBDs) are lifelong disorders predominantly present in developed countries. In their pathogenesis, an interaction between genetic and environmental factors is involved. This practice guide, prepared on behalf of the European Society of Pathology and the European Crohn's and Colitis Organisation, intends to provide a thorough basis for the histological evaluation of resection specimens and biopsy samples from patients with ulcerative colitis or Crohn's disease. Histopathologically, these diseases are characterised by the extent and the distribution of mucosal architectural abnormality, the cellularity of the lamina propria and the cell types present, but these features frequently overlap. If a definitive diagnosis is not possible, the term indeterminate colitis is used for resection specimens and the term inflammatory bowel disease unclassified for biopsies. Activity of disease is reflected by neutrophil granulocyte infiltration On behalf of the European Society of Pathology (ESP) and the European Crohn's and Colitis Organisation (ECCO).
Pathology of inflammatory bowel diseases (IBD): variability with time and treatment
Colorectal Disease, 2008
The diagnosis of chronic idiopathic IBD and the differential diagnosis between Crohn's disease and ulcerative colitis can be made in most cases on cumulative clinical, radiological, endoscopical, biochemical and pathological evidence. Diagnostic dif®culties can however, occur in fulminant colitis, in early onset disease and in longstanding disease. The microscopic evaluation of disease activity is based on the presence of active in¯ammation. Effective medical treatment has however, an in¯uence upon the morphology and the evolution of the lesions and hence can affect the diagnostic features and the microscopic features used for the assessment of disease activity. A literature review was performed on clinical drug trials in IBD and the effect of the drugs upon the microscopic features. Several studies have shown that the diagnostic microscopic features and the features characteristic for disease activity vary with time and treatment. For an adequate analysis of biopsy samples of patients with IBD the pathologist should be aware of the duration of the symptoms and the type of treatment given to the patient.
Inflammatory bowel disease-related lesions in the duodenal and gastric mucosa
Scandinavian Journal of Gastroenterology, 2009
Objective. In 10Á15% of patients with colorectal inflammatory bowel disease it is not possible to determine whether they have Crohn's disease or ulcerative colitis and they are therefore classified as having inflammatory bowel disease unclassified (IBDU) (formerly referred to as ''indeterminate colitis''). The aim of this study was to determine whether upper endoscopy with biopsies could be a useful tool for diagnosing patients with colorectal inflammatory disease. Material and methods. Fifty-two patients (14 colorectal Crohn's disease, 19 ulcerative colitis, 6 IBDU, 8 microscopic colitis and 5 without IBD) were examined by upper endoscopy. Biopsies from gastric and duodenal mucosa were examined histologically and the frequency of focal cryptitides was estimated. Helicobacter pylori-positive patients were excluded. Results. Focal cryptitides (sometimes called focally enhanced gastritis) were found in 8/14 of patients with Crohn's disease, 4/19 patients with ulcerative colitis, 2/6 patients with IBDU, 2/8 of patients with microscopic colitis and in 2/5 patients without IBD. Conclusions. Focal cryptitides are more commonly found in gastric and/or duodenal mucosa in patients with colorectal Crohn's disease than in other patients. Upper endoscopy with mucosal biopsies contributes towards a diagnosis in patients with colitis.
Inflammatory Bowel Diseases: Controversies in the Use of Diagnostic Procedures
Digestive Diseases, 2009
The term inflammatory bowel disease (IBD) denotes a genetically, immunologically and histopathologically heterogeneous group of inflammatory bowel disorders classified at present time as ulcerative colitis (UC), Crohn’s disease (CD) and indeterminate colitis (IC). Diagnosis of IBD is based on a non-strictly defined combination of clinical and diagnostic parameters. In order to guide the treatment, patients must be assessed by determining IBD phenotype, disease extension and distribution, extraintestinal manifestations, disease behavior, disease severity and drug responsiveness. Each element of the diagnostic process cannot be looked at alone, but has to be incorporated into general clinical assessment, bearing in mind that different phenotypes and age groups require specific diagnostic solutions. Advances in technology provided the possibility for the assessment of the entire digestive system with endoscopy leading the way. Sophisticated imaging methods made the analysis of the bowe...
International journal of health sciences
Inflammatory bowel diseases (IBDs) are chronic inflammatory diseases that often relapse and divided into two types, Crohn’s disease (CD) and ulcerative colitis (UC). Histopathological findings in colonic mucosal biopsy with clinical diagnosis suspicious IBD can vary and overlap. Therefore, criteria and guidelines have been created to improve the diagnostic accuracy. This descriptive observational study was performed retrospectively with cross sectional approach. 122 samples of colonic mucosal biopsies with clinical diagnosis of suspicious IBD were retrieved from histopathological archives in the Anatomical Pathology Laboratorium of Dr. Soetomo Hospital, Surabaya during period 1st January 2015 - 31st December 2019. The most common histopathological feature found in colonic mucosal biopsies with clinical diagnosis of suspicious IBD was crypt distortion (97/79.50% samples), and the least was irregularity of surface epithelium (30/24.59% samples). 10 of 122 samples was concordant with t...
Pathological analysis of lesions within intestines resected due to ulcerative colitis
Polish journal of pathology : official journal of the Polish Society of Pathologists, 2006
Ulcerative colitis (UC) and Lesniowski-Crohn's disease together constitute a type of intestinal pathology known as Inflammatory Bowel Disease. The etiology of UC still remains unknown, however some epidemiological data suggest the role of bacteria and viruses and also some habitual as well as environmental factors like smoking, diet, drugs, geographical and social status, as well as stress. The genetic predisposition is also suggested. UC affects young people in 2nd - 4th decades of life. Exacerbations of the disease may result in the necessity of surgical treatment, typically in the form of total proctocolectomy accompanied by the subsequent formation of ileo-pouch-anal anastomosis. The aim of our study was to analyze morphological pictures of resected specimens. We analyzed 67 cases (40 women and 27 men) of UC with the special interest being focused at macro- as well as microscopic features of the intestines resected. We reviewed macroscopic characteristics of intestines (i.e....
Disease Characteristics of Inflammatory Bowel Disease (IBD)
Journal of Gastrointestinal Surgery, 2011
Background Inflammatory bowel diseases (IBD) include ulcerative colitis (UC) and Crohn's disease (CD), which are chronic inflammatory conditions affecting the gastrointestinal tract. There are only few published data on disease characteristics of IBD related to South Asia. Objective To provide the disease characteristics of the IBD patients who presented to a tertiary care hospital in South Asia. Methods Patients with an established diagnosis of IBD were identified after a review of their medical records and demographics, and disease characteristics and indications for surgical treatment were analyzed. Results A total of 184 patients (women=101, 54.9%; UC=153, 83.2%) were included. Female preponderance was observed for UC (male/female ratio =1:1.5) and male for CD (male/female=2:1). Mean age at the time of diagnosis was 36.3 (range 7-71) years. CD was diagnosed at a significantly younger age than UC (27.35±10.22 vs. 38.14±13.05 years, p<0.0001). CD showed a peak age of onset in the third decade and that for UC was in the fourth decade. The mean duration of IBD was 8.17 (range 1-28) years. Presenting complaint of the majority (73.7%) of UC patients was blood and mucous diarrhea and that for CD (77.4%, 24/31) was left-sided abdominal pain. Only 9.5% (n=18) had at least one extra-intestinal manifestation. Among UC patients, 51.7% (n=79) had left-sided colitis and panproctocolitis was found in 18.3% (n=28). In IBD patients, 14.1% (n=26) underwent surgery. Only one patient developed malignancy. Conclusions The majority of UC patients had left-sided colitis. CD compared to UC was diagnosed at a younger age. However, compared to data reported for some Western countries, extra-intestinal manifestations and malignancy rates were lower.
Early microscopic findings in preclinical inflammatory bowel disease
Digestive and Liver Disease, 2020
Background: The immune response involved in the pathogenesis of Inflammatory Bowel Disease (IBD) may be present years before the diagnosis, but the characteristics of the disease during the preclinical period have been scarcely investigated. Aim: To describe the microscopic findings of preclinical IBD and its relationship with the natural history of the disease. Methods: Medical records from all patients with an incidental diagnosis of IBD during a screening colonoscopy were included in this multicentric and retrospective study. We assessed 15 histologic items in the biopsy samples at diagnosis, and the Geboes score was calculated in patients with Ulcerative Colitis (UC). The main outcome was the development of gastrointestinal symptoms during follow-up. Results: We included 110 patients (79 UC, 24 Crohn's Disease (CD) and 7 with unclassified disease). In UC the most common histologic findings were acute or chronic inflammatory infiltrate and crypt epithelial polymorphs, while in CD we observed acute or chronic neutrophilic infiltrate and epithelial irregularity. Granuloma were only observed in 4% of CD patients. Crypt distortion and the infiltration of neutrophils in the epithelium were associated with a higher risk of developing symptomatic disease. Conclusions: Preclinical IBD shows specific microscopic findings and they are associated with the progression to symptomatic disease.