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Talk:Inflammatory bowel disease (view source)
Revision as of 16:25, 25 October 2013
, 16:25, 25 October 2013→Architectural changes: new section
(Created page with "==Crohn's disease== ===Microscopic description=== A. The sections show small bowel mucosa with well-formed, non-caseating granuloma. There is cryptitis, villous blunting, focal ...") |
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===Comment=== | ===Comment=== | ||
The histomorphological findings (patchy inflammation, granulomas, ileitis, paneth cell metaplasia, crypt loss, crypt elongation) are suggestive of Crohn's disease. An infective etiology should be considered, as it cannot be definitely excluded on pathologic grounds. | The histomorphological findings (patchy inflammation, granulomas, ileitis, paneth cell metaplasia, crypt loss, crypt elongation) are suggestive of Crohn's disease. An infective etiology should be considered, as it cannot be definitely excluded on pathologic grounds. | ||
== Query early IBD == | |||
<pre>COLON, BIOPSIES: | |||
- MINIMAL FOCAL ACTIVE COLITIS. | |||
COMMENT: | |||
Cryptitis is seen in a small number of crypts in only one of a larger number of tissue | |||
fragments. Nonspecific patchy epithelial apoptosis is present in multiple fragments. | |||
No chronic changes are apparent. The number of intraepithelial lymphocytes is within | |||
normal limits. Clinical correlation is suggested. | |||
</pre> | |||
== IBD dysplasia == | |||
<pre> | |||
COLON, HEPATIC FLEXURE, BIOPSY: | |||
- LOW-GRADE DYSPLASIA, SEE COMMENT. | |||
COMMENT: | |||
The area of dysplasia may represent an IBD-related area of polypoid dysplasia | |||
or a sporadic adenoma. This distinction cannot be made on morphology alone; | |||
clinical/endoscopic correlation is required. | |||
</pre> | |||
== Re-anastomosis with mechanical reactive changes == | |||
<pre> | |||
"SMALL BOWEL", RESECTION AND NEW ANASTOMOSIS: | |||
- SMALL BOWEL WITH FOCAL MUCOSA EROSIONS -- FAVOUR MECHANICAL, SEE COMMENT. | |||
- LARGE BOWEL WITH POST-SURGICAL CHANGES, NEGATIVE FOR ACTIVE INFLAMMATION. | |||
- SKIN WITH REACTIVE CHANGES. | |||
- NEGATIVE FOR DYSPLASIA. | |||
COMMENT: | |||
The small bowel section focally shows erosions at the tips of the villi close to the | |||
interface with the skin; this is favoured to be a mechanical phenomenon. The small bowel | |||
more distant from the small bowel-skin junction shows no active inflammation. | |||
One foreign body-type granuloma is present. No other granulomata are identified. | |||
The bowel shows increased eosinophils and intraepithelial lymphocytes, and basal | |||
plasmacytosis compatible with a chronic inflammatory process. | |||
</pre> | |||
== Architectural changes == | |||
http://www.histopath.com.au/assets/documents/Inflammatory%20bowel%20disease.pdf | |||
Changes: | |||
*Gland branching. | |||
*Gland shortening. | |||
*Decreased gland density. | |||
*Variation of gland diameter. | |||