ulcerative colitis
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Ulcerative colitis (UC) is generally considered an inflammatory disorder that always involves the rectum and may also involve more proximal portions of the colon, but always in a diffuse and continuous (non-segmental) fashion.
Earlier biopsy studies have shown that both rectal sparing and patchy disease may occur during the natural history of UC and may, in fact, be accentuated by oral or enema therapy. (#20410806#)
Synopsis
chronic inflammatory infiltrate (Grade 1)
lamina propria neutrophils and eosinophiles (Grade 2)
neutrophils in epithelium (Grade 3)
crypt destruction (Grade 4)
mucosal ulceration or ulceration (Grade 5)
colonic inflamatory pseupolyp
Associations
backwash ileitis
postcolectomy pouchitis
diffuse duodenitis (#11023103#)
Complications
colonic adenoma
dysplasia-associated lesion or mass (DALM)
ulcerative colitis-associated colorectal adenocarcinoma
Differential diagnosis
colonic Crohn disease
References
Tsang P, Rotterdam H. Biopsy diagnosis of colitis: possibilities and pitfalls.Am J Surg Pathol 1999 Apr;23(4):423-30
Kleer CG, Appelman HD. Ulcerative colitis: patterns of involvement in colorectal biopsies and changes with time.Am J Surg Pathol 1998 Aug;22(8):983-9
Variants
steroid-refractory ulcerative colitis
- association with CMV infection (#15104299#)
Videos
Colonoscopy of ulcerative colitis
References
Rectal sparing and skip lesions in ulcerative colitis: a comparative study of endoscopic and histologic findings in patients who underwent proctocolectomy. Joo M, Odze RD. Am J Surg Pathol. 2010 May;34(5):689-96. PMID: #20410806#
In situ evidence of involvement of Schwann cells in ulcerative colitis: autocrine and paracrine signaling by A disintegrin and metalloprotease-17-mediated tumor necrosis factor alpha production. Mosnier JF, Jarry A, Camdessanché JP, Antoine JC, Laboisse CL. Hum Pathol. 2009 Apr 17. PMID: #19376560#
Pathologic Features of Ulcerative Colitis in Patients With Primary Sclerosing Cholangitis: A Case-control Study. Joo M, Abreu-E-Lima P, Farraye F, Smith T, Swaroop P, Gardner L, Lauwers GY, Odze RD. Am J Surg Pathol. 2009 Mar 17. PMID: #19295408#
Sandle GI. Pathogenesis of diarrhea in ulcerative colitis: new views on an old problem. J Clin Gastroenterol. 2005 Apr;39(4 Suppl 2):S49-52. PMID: #15758659#
Podolsky DK. Inflammatory bowel disease. N Engl J Med. 2002 Aug 8;347(6):417-29. PMID: #12167685#
Price AB, Morson BC. Inflammatory bowel disease: the surgical pathology of Crohn’s disease and ulcerative colitis. Hum Pathol. 1975 Jan;6(1):7-29. PMID: #1089084#