Talk:Inflammatory bowel disease

Crohn's disease

Microscopic description

A. The sections show small bowel mucosa with well-formed, non-caseating granuloma. There is cryptitis, villous blunting, focal crypt abscess, mucosal ulceration, and crypt loss.

B. The sections shows colonic-type mucosa with a non-caseating granuloma and cryptitis.

C-D. The sections show colonic-type mucosa with patchy inflammation. There are foci of cryptitis, edema and mild architectural changes.

E-H. The sections show colonic-type mucosa with focal Paneth cell metaplasia and mild architectural changes including crypt elongation and crypt drop-out.

Final diagnosis

A. Terminal ileum, biopsy - Moderate granulomatous ilietis. B. Ileal-cecal valve, biopsy - Mild active granulomatous ileal-cecal valve-itis. C. Cecum, biopsy - Mild patchy active colitis. D. Ascending colon, biopsy - Mild patchy active colitis. E. Transverse colon, biopsy - Chronic inflammatory changes. No active colitis. F. Descending colon, biopsy - Chronic inflammatory changes. No active colitis. G. Sigmoid colon, biopsy - Chronic inflammatory changes. No active colitis. H. Rectum, biopsy - Chronic inflammatory changes. No active colitis.

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.