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ulcerative colitis
Tuesday 2 March 2004
Definition: 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)
Images
ulcerative colitis : ruptured crypt granuloma : mucous extravasation after cryptic dysruption
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
Variants
steroid-refractory ulcerative colitis
- association with CMV infection (15104299)
Videos
Colonoscopy of ulcerative colitis
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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
Morphologic findings in upper gastrointestinal biopsies of patients with ulcerative colitis: a controlled study. Lin J, McKenna BJ, Appelman HD. Am J Surg Pathol. 2010 Nov;34(11):1672-7. PMID: 20962621
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
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 Jun;33(6):854-62. PMID: 19295408
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
Alterations in the immunohistochemical expression of Das-1 and CG-3 in colonic mucosal biopsy specimens helps distinguish ulcerative colitis from Crohn disease and from other forms of colitis. Yantiss RK, Das KM, Farraye FA, Odze RD. Am J Surg Pathol. 2008 Jun;32(6):844-50. PMID: 18408596
Hyperplastic/serrated polyposis in inflammatory bowel disease: a case series of a previously undescribed entity. Srivastava A, Redston M, Farraye FA, Yantiss RK, Odze RD. Am J Surg Pathol. 2008 Feb;32(2):296-303. PMID: 18223333
AMACR immunostaining is useful in detecting dysplastic epithelium in Barrett’s esophagus, ulcerative colitis, and Crohn’s disease. Dorer R, Odze RD. Am J Surg Pathol. 2006 Jul;30(7):871-7. PMID: 16819330
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
Pediatric patients with untreated ulcerative colitis may present initially with unusual morphologic findings. Glickman JN, Bousvaros A, Farraye FA, Zholudev A, Friedman S, Wang HH, Leichtner AM, Odze RD. Am J Surg Pathol. 2004 Feb;28(2):190-7. PMID: 15043308
Patterns of inflammation in mucosal biopsies of ulcerative colitis: perceived differences in pediatric populations are limited to children younger than 10 years. Robert ME, Tang L, Hao LM, Reyes-Mugica M. Am J Surg Pathol. 2004 Feb;28(2):183-9. PMID: 15043307
Histopathology of ulcerative colitis in initial rectal biopsy in children. Washington K, Greenson JK, Montgomery E, Shyr Y, Crissinger KD, Polk DB, Barnard J, Lauwers GY. Am J Surg Pathol. 2002 Nov;26(11):1441-9. PMID: 12409720
Inflammatory bowel disease. Podolsky DK. N Engl J Med. 2002 Aug 8;347(6):417-29. PMID: 12167685
Colectomy for ulcerative colitis. Joshi VV, Ricci A Jr. Am J Surg Pathol. 1998 Aug;22(8):1040-1. PMID: 9706988
Ulcerative colitis: patterns of involvement in colorectal biopsies and changes with time. Kleer CG, Appelman HD. Am J Surg Pathol. 1998 Aug;22(8):983-9. PMID: 9706978
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
