Microscopic Colitis in Routine Colonoscopies
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Lymphocytic colitis (LC) and collagenous colitis (CC), both known as microscopic colitis (MC), are uncommon entities with increasing incidence as more clinicians take biopsies from macroscopically normal colons and as pathologists use more rigorous diagnostic criteria to be confident of the diagnosis. Information on the incidence of this type of colitis is limited and based on reported cases. The purpose of this work is to estimate the incidence of LC and CC in reviewed routine colonoscopies. We reviewed 2815 colonoscopies performed at a tertiary referral center with an open-access service using restricted histological criteria in order to establish the frequency rate of LC and CC in routine colonoscopic biopsy material. Cases suspicious for MC were stained with Masson's trichrome or Congo red stain and immunohistochemically for lymphocytes, where appropriate. Review of routine colonoscopic biopsies showed that MC is underreported in our colonoscopic material. Incidence rates of LC and CC (0.9 and 0.4, respectively) were based on morphological assessment of colonoscopic biopsies using stringent criteria together with clinical data and after differentiation with other lesions which can mimic MC. The 10.2% rate of this type of colitis in patients with chronic watery diarrhea indicates the necessity to consider these lesions in older individuals with diarrhea and normal endoscopical colonic mucosa.
Key Wordsmicroscopic colitis incidence pathology lymphocytic colitis collagenous colitis
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- 2.Bogomoletz WV: Collagenous, microscopic and lymphocytic colitis. An evolving concept. Virchows Archiv 424:573–579, 1994Google Scholar
- 3.Jawahari A, Talbot JC: Microscopic and collagenous colitis. Histopathology 29:101–110, 1996Google Scholar
- 8.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 heterogenous entity. Am J Surg Pathol 23:1068–1074, 2000Google Scholar
- 16.Nasir A, Garb J, Nash S: Collagenous and lymphocytic colitis increasing frequency of biopsy diagnosis in the late nineties. Mod Pathol 13(1):85, 2000 (abstract)Google Scholar
- 18.Olsen M, Eriksson S, Bohr J, Jarnerot G, Tysk C: Microscopic colitis: a common diarrhoeal disease. An epidemiological study in Orebro, Sweden, 1993–1998. Gut 53:345–350, 2004Google Scholar
- 20.Pierrugues R, Bories P, Barneon G, Bernard N, Michel H: Collagen colitis. Reflections apropos of 40 patients. Gastroenterol Clin Biol 13:811–815, 1989Google Scholar
- 23.Giardiello FM, Lazenby AJ, Bayless TM: Lymphocytic (microscopic) colitis. Clinicopathologic study of 18 patients and comparison to collagenous colitis. Dig Dis Sci 34:1730–1738, 1989Google Scholar
- 25.Jaskiewicz K, Price S, Zak J, Louwrens HD: Lymphocytic gastritis in non-ulcer dyspepsia. Dig Dis Sci 36:1079–1083, 1990Google Scholar
- 26.Mills LR, Schuman BM, Thompson WO: Lymphocytic colitis. A definable clinical and histological diagnosis. Dig Dis Sci 38:1147–1151, 1993Google Scholar