Histologic Changes in Defunctioned Rectums in Patients With Inflammatory Bowel Disease

Asplund, Sheryl L.; Gramlich, Terry L.; Fazio, Victor W.; Petras, Robert E.

doi:10.1007/s10350-004-6394-7

Cited by 55 publications

(19 citation statements)

References 18 publications

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“…However, histological features in biopsies (and resections) from a diverted segment do not distinguish reliably between UC and CD. For example, granulomas in DPC may be more common when the underlying pathology is CD than when it is UC,89 but can also occur in the latter and in other settings 87 90…”

Section: Mimics Of Ibdmentioning

confidence: 99%

Inflammatory bowel disease biopsies: updated British Society of Gastroenterology reporting guidelines

2013

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Accurate histopathological assessment of biopsies is important for the diagnosis, subclassification, and management of chronic idiopathic inflammatory bowel disease (IBD). British Society of Gastroenterology (BSG) guidelines for the initial histopathological diagnosis of IBD were published in 1997. Changes since then include: more widespread use of full colonoscopy; greater recognition of the effects of time and treatment; improved documentation of variations in anatomical distribution; better understanding of the mimics of IBD; significant progress in clinical management; and modifications of terminology. Accordingly, an update is required. These revised guidelines aim to optimise the quality and consistency of reporting of biopsies taken for the initial diagnosis of IBD by summarising the literature and making recommendations based on the available evidence. Advice from existing clinical guidelines is also taken into account. Among the subjects discussed are: distinguishing IBD from other colitides, particularly infective colitis; subclassification of IBD (as ulcerative colitis, Crohn's disease, or IBD unclassified); the discriminant value of granulomas; aspects of disease distribution, including discontinuity in ulcerative colitis; time-related changes; differences between paediatric and adult IBD; the role of ileal and upper gastrointestinal biopsies; differential diagnoses such as diverticular colitis and diversion proctocolitis; and dysplasia. The need to correlate the histological features with clinical and endoscopic findings is emphasised. An approach to the conclusion of an IBD biopsy report based on the acronym Pattern, Activity, Interpretation, Dysplasia (PAID) is suggested. The key recommendations are listed at the end of the document.

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Section: Mimics Of Ibdmentioning

confidence: 99%

Inflammatory bowel disease biopsies: updated British Society of Gastroenterology reporting guidelines

2013

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“…Diverted rectal specimens were not used to differentiate ulcerative colitis and Crohns disease, due to their well reported tendency to nonspecifically mimic the transmural features of Crohns disease. [13][14][15][16] …”

Section: Human Colonic Tissuesmentioning

confidence: 99%

MicroRNA expression patterns in indeterminate inflammatory bowel disease

Cao

Zhang

et al. 2013

Modern Pathology

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“…The inflammation in diversion proctocolitis may mimic IBD [172], but the distinction is made by the absence of significant crypt distortion [173] and the lymphoid hyperplasia is characteristic. Exacerbation of inflammation with unusual features may be seen in diverted large bowel of patients with preexisting diagnosis of ulcerative colitis including fissuring ulceration and granulomas that should not be construed as evidence of Crohn's disease [174]. Microcarcinoids have also been reported in the diverted rectum in ulcerative colitis [175].…”

Section: Diversion Colitismentioning

confidence: 97%

“…Microcarcinoids have also been reported in the diverted rectum in ulcerative colitis [175]. In contrast, the histological appearances of diverted Crohn's disease typically show 'burnt-out disease' with fibrosis and a lack of active inflammation [168,174]. Granulomas become effete with hyalinization [176].…”

Section: Diversion Colitismentioning

confidence: 98%

Biopsy interpretation of colonic biopsies when inflammatory bowel disease is excluded

et al. 2012

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The interpretation of colonic biopsies related to inflammatory conditions can be challenging because the colorectal mucosa has a limited repertoire of morphologic responses to various injurious agents. Only few processes have specific diagnostic features, and many of the various histological patterns reflect severity and duration of the disease. Importantly the correlation with endoscopic and clinical information is often cardinal to arrive at a specific diagnosis in many cases.

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Histologic Changes in Defunctioned Rectums in Patients With Inflammatory Bowel Disease

Cited by 55 publications

References 18 publications

Inflammatory bowel disease biopsies: updated British Society of Gastroenterology reporting guidelines

Inflammatory bowel disease biopsies: updated British Society of Gastroenterology reporting guidelines

MicroRNA expression patterns in indeterminate inflammatory bowel disease

Biopsy interpretation of colonic biopsies when inflammatory bowel disease is excluded

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