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Difference between revisions of "Inflammatory bowel disease"
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Features helpful for the diagnosis of IBD - as based on a study:<ref name=pmid10048734>{{cite journal |author=Tanaka M, Riddell RH, Saito H, Soma Y, Hidaka H, Kudo H |title=Morphologic criteria applicable to biopsy specimens for effective distinction of inflammatory bowel disease from other forms of colitis and of Crohn's disease from ulcerative colitis |journal=Scand. J. Gastroenterol. |volume=34 |issue=1 |pages=55–67 |year=1999 |month=January |pmid=10048734 |doi= |url=}}</ref> | Features helpful for the diagnosis of IBD - as based on a study:<ref name=pmid10048734>{{cite journal |author=Tanaka M, Riddell RH, Saito H, Soma Y, Hidaka H, Kudo H |title=Morphologic criteria applicable to biopsy specimens for effective distinction of inflammatory bowel disease from other forms of colitis and of Crohn's disease from ulcerative colitis |journal=Scand. J. Gastroenterol. |volume=34 |issue=1 |pages=55–67 |year=1999 |month=January |pmid=10048734 |doi= |url=}}</ref> | ||
#Basal inflammation, i.e. crypt base, plasmacytosis with severe chronic inflammation. | #Basal inflammation, i.e. crypt base, plasmacytosis with severe chronic inflammation. | ||
#*Basal cell plasmacytosis makes an infectious etiology less likely.<ref> | #*Basal cell plasmacytosis makes an infectious etiology less likely.<ref name=Kirsch>Kirsch, R. 13 December 2010.</ref> | ||
#*"Basal plasmacytosis" = plasma cells in the lamina propria between the crypts and muscularis mucosae.<ref>{{cite web |url=http://www.histopathology-india.net/UlCol.htm |title=Pathology of ulcerative colitis |author= |date= |work= |publisher= |accessdate=17 January 2011}}</ref> | #*"Basal plasmacytosis" = plasma cells in the lamina propria between the crypts and muscularis mucosae.<ref>{{cite web |url=http://www.histopathology-india.net/UlCol.htm |title=Pathology of ulcerative colitis |author= |date= |work= |publisher= |accessdate=17 January 2011}}</ref> | ||
#Crypt architectural abnormalities. | #Crypt architectural abnormalities. | ||
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# If you see architectural distortion (e.g. crypt branching) in the left colon, look for Paneth cells. | # If you see architectural distortion (e.g. crypt branching) in the left colon, look for Paneth cells. | ||
# The hepatic flexure is considered the divider for normal paneth cells and abnormal paneth cells, i.e. paneth cells proximal to the hepatic flexure are normal; paneth cells distal to the hepatic flexure are abnormal.<ref>STC. 14 December 2009.</ref> | # The hepatic flexure is considered the divider for normal paneth cells and abnormal paneth cells, i.e. paneth cells proximal to the hepatic flexure are normal; paneth cells distal to the hepatic flexure are abnormal.<ref>STC. 14 December 2009.</ref> | ||
# Stretching of tissue may mimic atrophy; tip-off it is artefact: thinning of mucosa.<ref> | # Stretching of tissue may mimic atrophy; tip-off it is artefact: thinning of mucosa.<ref name=Kirsch>Kirsch, R. 13 December 2010.</ref> | ||
Images: | Images: | ||
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===Grading=== | ===Grading=== | ||
*Several systems exists.<ref> | *Several systems exists.<ref name=Kirsch>Kirsch, R. 13 December 2010.</ref> | ||
*One that is often cited is by Gupta et al..<ref name=pmid17919486>{{cite journal |author=Gupta RB, Harpaz N, Itzkowitz S, ''et al.'' |title=Histologic inflammation is a risk factor for progression to colorectal neoplasia in ulcerative colitis: a cohort study |journal=Gastroenterology |volume=133 |issue=4 |pages=1099–105; quiz 1340–1 |year=2007 |month=October |pmid=17919486 |pmc=2175077 |doi=10.1053/j.gastro.2007.08.001 |url=}}</ref> | *One that is often cited is by Gupta et al..<ref name=pmid17919486>{{cite journal |author=Gupta RB, Harpaz N, Itzkowitz S, ''et al.'' |title=Histologic inflammation is a risk factor for progression to colorectal neoplasia in ulcerative colitis: a cohort study |journal=Gastroenterology |volume=133 |issue=4 |pages=1099–105; quiz 1340–1 |year=2007 |month=October |pmid=17919486 |pmc=2175077 |doi=10.1053/j.gastro.2007.08.001 |url=}}</ref> | ||
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| '''Severe''' | | '''Severe''' | ||
|- | |- | ||
| "A grading scheme"<ref> | | "A grading scheme"<ref name=Kirsch>Kirsch, R. 13 December 2010.</ref> | ||
| - | | - | ||
| cryptitis | | cryptitis | ||