Increased numbers of macrophages in noninflamed gastroduodenal mucosa of patients with Crohn's disease (original) (raw)
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American Journal of Gastroenterology - AMER J GASTROENTEROL, 2000
OBJECTIVE:In 10% of cases it may be difficult to differentiate Crohn’s colitis from ulcerative colitis. Distinguishing the two conditions is important because they are distinct entities with different therapeutic implications. Noncaseating granulomas are usually considered diagnostic of Crohn’s disease. We previously reported that the presence of a microaggregate of immunostained macrophages within the noninflamed gastroduodenal mucosa was a characteristic finding of Crohn’s disease. The aim of this study was to determine whether a microaggregate of immunostained macrophages can be a reliable marker for differentiating Crohn’s colitis from ulcerative colitis.METHODS:We investigated the presence of microaggregates of immunostained macrophages and epithelioid cell granulomas in biopsy specimens taken from the noninflamed gastroduodenal mucosa of 22 known Crohn’s colitis patients and 23 established ulcerative colitis patients. The incidence of microaggregates and granulomas was compare...
Inflammatory Bowel Disease: Anatomical and Histopathological Study
Worldwide, the frequency of chronic inflammatory bowel disease (CIBD), including ulcerative colitis (UC) and Crohn's disease (CD) increased rapidly through the last century making their histopathological diagnosis daily task for all pathologists. The accurate histopathological diagnosis of UC and CD requires an intimate correlations between the clinical, laboratory and endoscopic findings in conjunction to the suitable obtained biopsy material, as there are several diagnostic confusions between CIBD and non CIBD forms. The aim of this study was to focus and analyze certain practically selected histopathological features for the diagnosis of UC and CD including crypt architectural abnormalities, inflammation and an associated dysplasia or adenocarcinoma. This present study was performed on 100 specimens of tissue samples taken from small and large bowel including 3 ileocecal resections which were done for suspected an IBD. All the tissue samples received fixed in 10% neutral buffered formalin fixative solution, and paraffin-embedded tissue sections were prepared and examined microscopically for the histopathological features which distinguishing CIBD from non CIBD colitis. This study revealed 95 cases CIBD, among them 55 cases CD and 40 cases were UC, whereas the remaining 5 cases were non CIBD colitis. This study concluded that the diagnosis of IBD needs interdepartmental correlations to avoid under- or over-diagnosis. As well as the accurate discrimination of CIBD from non CIBD forms, differentiate UC from CD, and to identify any dysplastic lesions which is the backbone for therapeutic and prognostic strategies.
Endoscopic and pathologic changes of the upper gastrointestinal tract in Crohn's disease
BioMed research international, 2014
Crohn's disease (CD) may involve any part of the gastrointestinal tract. We assessed the prevalence and features of upper gastrointestinal (UGI) lesions in CD. This was a retrospective study that included 138 CD patients that underwent esophagogastroduodenoscopy (EGD). The rate of Crohn's specific endoscopic lesions in the esophagus, stomach, and duodenum was assessed, and immunohistochemical analysis was performed. Changes in the UGI lesions were assessed in those who had two or more EGD. Of 138 patients, 51.3% had Crohn's specific UGI lesions. The rates of Crohn's specific lesion in the esophagus, upper-to-middle stomach, lower stomach, duodenal bulb, and 2nd portion of the duodenum were 6.5%, 47.8%, 24.6%, 31.9%, and 18.1%, respectively. Granulomas were detected in 6.1%, 25.0%, and 11.4% in the upper-to-middle stomach, lower stomach, and duodenal bulb, respectively, but none in the esophagus and 2nd portion of the duodenum. Thirty-seven were analyzed for Helicobac...
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.
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
Functional and morphological changes in small bowel of crohn's disease patients
Digestive Diseases and Sciences, 1995
Morphological and functional changes were examined in the upper jejunum and terminal ileum of 18 patients suffering from Crohn's disease. Intestinal permeability, biochemical determination of enzymatic activities, and morphologic evaluation of the severity of the lesions were evaluated. Ulcerative colitis and irritable bowel syndrome patients served as controls. We found abnormal lactulose-mannitol tests in all patients with active Crohn's disease. Permeability changes correlated with increased crypt cell proliferation, as indicated by thymidine kinase activity. A significant reduction in brush border enzyme activities was seen in the terminal ileum, but no significant change was observed in the unaffected upper jejunum. The number of mast cells was increased in the diseased ileum. We conclude that the site of inflammation and the healing capacity of the epithelium are important in determining functional and biochemical abnormalities in active Crohn's disease. Changes may be dependent on the type and number of immune cells involved in the inflammatory process.
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).
Alimentary Pharmacology and Therapeutics, 2005
Background: The stomach and the duodenum are frequent sites of involvement by diminutive lesions in Crohn's disease (CD). Aim: To assess mucosal proinflammatory cytokines and chemokines in gastroduodenal lesions of CD. Methods: 13 C-Urea breath test and upper endoscopy were performed in 29 CD patients and seven control subjects, and biopsy specimens were obtained from the gastric cardia and the duodenum. Histology and mucosal levels of IL-1b, IL-8/CXCL8 and RANTES/ CCL5 were assessed and compared according to the presence of gastric cardial lesion [bamboo joint-like appearance (BJA)] and duodenal lesion (notched appearance, aphthous erosion and polypoid lesion). In 11 CD patients, these procedures were repeatedly performed after administration of famotidine.
Abnormalities in the upper gastrointestinal tract in inflammatory bowel disease
Inflammopharmacology, 2007
The predominant histopathologic feature of infl ammatory bowel disease is the infi ltration of acute and chronic infl ammatory cells, including polymorphonuclear neutrophils, macrophages and lymphocytes, in the affected intestine. Helicobacter pylori is recognized as the most common cause of upper gastrointestinal lesions, and Helicobacter pylori-associated gastritis is characterized by increased numbers of acute and chronic infl ammatory cells. The pathogenesis of infl ammatory bowel disease or Helicobacter pylori-associated gastritis involves immunological abnormalities, including the defi cient or excessive expression of cytokines. The chronic infl ammatory process in patients with Crohn's disease may affect any part of the gastrointestinal tract, whereas ulcerative colitis affects mainly the colon and rectum. Here, we discuss abnormalities in the upper gastrointestinal tract in infl ammatory bowel disease. Although the prevalence rate of Helicobacter pylori infection is low in Crohn's disease, these patients often have abnormalities in the upper gastrointestinal tract.