The Differential Diagnosis of Colitis in Endoscopic Biopsy Specimens: A Review Article

Cerilli, Lisa A.; Greenson, Joel K.

doi:10.5858/arpa.2012-0205-ra

Cited by 76 publications

(39 citation statements)

References 66 publications

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“…The majority of participants had at least one measure of colonic inflammation; inflammation was more common on the right side than on the left (Table 3), likely a measure of the normal baseline levels of lymphoplasmatic cell infiltrates in the proximal colon [13]. Measures of chronic inflammation were also more common than measures of acute inflammation.…”

Section: Resultsmentioning

confidence: 99%

The association between circulating high-sensitivity C-reactive protein concentration and pathologic measures of colonic inflammation

Joshu

Tsilidis

Peskoe

et al. 2014

Cancer Causes Control

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Purpose C-reactive protein (CRP), an inflammation marker, is associated with colorectal cancer (CRC) risk in some prospective studies. Whether increased CRP is indicative of colonic inflammation, a possible CRC cause, or of other sources of inflammation (e.g., adiposity), is unknown. Thus, we evaluated the association between CRP and colonic mucosal measures of inflammation. Methods 151 adults undergoing colonoscopy provided a blood sample and random left and right side colonic mucosal biopsies. Height and weight were measured and lifestyle information was collected. hsCRP was measured by immunoturbidometric assay. A gastrointestinal pathologist evaluated biopsies for 7 colonic inflammation measures. Of 119 participants with complete information, 24 had an inflammatory bowel disease (IBD) history and were analyzed separately. We calculated number of colonic inflammation measures present in both biopsies, and separately for right and left biopsies. Adjusted geometric mean hsCRP was calculated using linear regression, overall, by demographic and lifestyle factors, and inflammation measures. Results Most participants had ≥1 colonic inflammation measure (0: 21%, 1: 39%, ≥2: 40%). Adjusted mean hsCRP did not increase with increasing number of inflammation measures (0: 1.67; 1: 1.33; ≥2: 1.01 mg/L; p-trend=0.21). Obese (2.03 mg/L) and overweight (1.61 mg/L) participants had higher adjusted mean hsCRP than normal weight participants (0.62 mg/L; p-trend<0.0001). Patterns were similar for IBD history. Conclusions hsCRP concentration was not associated with colonic inflammation, although hsCRP increased with adiposity. The hsCRP-CRC association may be explained by residual confounding by other risk factors, such as adiposity, rather than by CRP marking colonic inflammation.

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Section: Resultsmentioning

confidence: 99%

The association between circulating high-sensitivity C-reactive protein concentration and pathologic measures of colonic inflammation

Joshu

Tsilidis

Peskoe

et al. 2014

Cancer Causes Control

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“…On the other hand, histological evidence of CAb or E/U is considered to reflect severe inflammation. However, these findings have a low frequency and are not considered to be very specific for ulcerative colitis …”

Section: Discussionmentioning

confidence: 99%

Correlation between histological findings and endoscopic findings in patients with ulcerative colitis: Basal plasmacytosis is an important finding suggesting active inflammation

Mitsuishi

2018

JGH Open

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Aims In clinical practice, patients of ulcerative colitis showing divergence between the histological findings and endoscopic findings are often encountered. Therefore, we compared histological findings with endoscopic findings, indicating the severity of the inflammation of ulcerative colitis. Methods and Results The study group comprised 191 patients (527 biopsy specimens) with ulcerative colitis who underwent lower gastrointestinal endoscopy with biopsy in our hospital from July 2015 to June 2016. Endoscopic findings of the mucosa at the biopsy site were classified into seven levels according to the severity of inflammation: noninflamed mucosa, red signs, loss of visible vascular patterns, granular mucosa, friable mucosa, spontaneous bleeding, and erosions/ulcers (E/U). All biopsy samples were examined for the presence or absence of five histological findings (basal plasmacytosis [BP], neutrophil infiltration, cryptitis, crypt abscess [CAb], and E/U), and the results were contrasted with endoscopic findings. The 191 patients comprised 123 (64.4%) males and 68 (35.6%) females, with a median age of 47 years (range, 8–82). Among the 527 specimens, the detection rates of BP, CAb, and E/U in mucosa with endoscopic E/U were 58.5, 27.4, and 18.3%. The detection rate of BP in mucosa with red signs was 22.4%; in mucosa, with loss of visible vascular patterns, it was 16.9%; in granular mucosa, it was 35.7%, and in mucosa with E/U, it was 58.5%. BP was frequently seen in severely inflamed mucosa associated with E/U on endoscopic examination. Conclusion BP was considered an important finding, suggesting the presence of active and severe inflammation.

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“…If observed, endoscopic mucosal nodularity may also be helpful in recognizing diversion colitis (Figure 2, D). 27 Behcet disease is an important differential diagnosis before a diagnosis of CD is made, especially in Asia (see ''CD in Asia'' below). …”

Section: Histologic Differential Diagnosis Of Ibdmentioning

confidence: 99%

Clinical Aspects of Idiopathic Inflammatory Bowel Disease: A Review for Pathologists

Lee¹,

Westerhoff²,

Shen³

et al. 2016

Archives of Pathology &Amp; Laboratory Medicine

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Context.—Idiopathic inflammatory bowel disease manifests with different clinical phenotypes showing varying behavior and risk for neoplasia. The clinical questions that are posed to pathologists differ depending on phase of the disease and the clinical circumstances. Understanding the clinical aspects of the dynamic disease process will enhance the role of pathology in optimizing the care of patients with inflammatory bowel disease. Objective.—To review clinical and surgical aspects of inflammatory bowel disease that are relevant to practicing pathologists. Data Sources.—The literature was reviewed. Conclusions.—Diagnosis and management of inflammatory bowel disease require an integrated evaluation of clinical, endoscopic, radiologic, and pathologic features. Therefore, close interaction between clinicians and pathologists is crucial. Having this team approach improves understanding of the pertinent clinical and surgical aspects of the disease and assists in the recognition of unusual presentation of variants, as well as mimics of idiopathic inflammatory bowel disease, by pathologists.

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The Differential Diagnosis of Colitis in Endoscopic Biopsy Specimens: A Review Article

Cited by 76 publications

References 66 publications

The association between circulating high-sensitivity C-reactive protein concentration and pathologic measures of colonic inflammation

The association between circulating high-sensitivity C-reactive protein concentration and pathologic measures of colonic inflammation

Correlation between histological findings and endoscopic findings in patients with ulcerative colitis: Basal plasmacytosis is an important finding suggesting active inflammation

Clinical Aspects of Idiopathic Inflammatory Bowel Disease: A Review for Pathologists

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