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lymphocytic colitis
Tuesday 8 February 2005
Digital case
HPC:327 : Lymphocytic colitis
Definition: Lymphocytic colitis is characterized histologically by an infiltrate of numerous T lymphocytes in the colonic epithelium, with excessive numbers defined as 20 or more intraepithelial lymphocytes (IELs) per 100 epithelial cells.
Clinical synopsis
Lymphocytic colitis is uncommon but not rare. The patients typically present with chronic watery diarrhea. The entity has been recognized only fairly recently, and the label was first proposed by Lazenby et al in 1989.
About 15% of these patients have celiac disease, which is also characterized by excessive numbers of intraepithelial lymphocytes in the villous epithelium of the small bowel. Others are likely linked to infectious outbreaks, but the majority of cases are idiopathic.
Microscopy
Lymphocytic colitis is characterized histologically by an infiltrate of numerous T lymphocytes in the colonic epithelium, with excessive numbers defined as 20 or more intraepithelial lymphocytes (IELs) per 100 epithelial cells.
Types
focal lymphocytic colitis
diffuse lymphocytic colitis
See also
microscopic colitis
References
Parfitt JR, Driman DK. Pathological effects of drugs on the gastrointestinal tract: a review. Hum Pathol. 2007 Apr;38(4):527-36. PMID: 17367604
Lazenby AJ, Yardley JH, Giardiello FM, Jessurun J, Bayless TM. Lymphocytic ("microscopic") colitis: a comparative histopathologic study with particular reference to collagenous colitis. Hum Pathol. 1989 Jan;20(1):18-28. PMID: 2912870
Goldblum JR, Wang N. Lymphocytic and collagenous colitis as possible patterns of Crohn’s colitis. Am J Surg Pathol. 2000 May;24(5):755-6; author reply 756-7. PMID: 10800997
Wang N, Dumot JA, Achkar E, Easley KA, Petras RE, Goldblum JR. Colonic epithelial lymphocytosis without a thickened subepithelial collagen table: a clinicopathologic study of 40 cases supporting a heterogeneous entity. Am J Surg Pathol. 1999 Sep;23(9):1068-74. PMID: 10478666
Goldstein NS, Gyorfi T. Focal lymphocytic colitis and collagenous colitis: patterns of Crohn’s colitis? Am J Surg Pathol. 1999 Sep;23(9):1075-81. PMID: 10478667