Colitis pp 49-89 | Cite as

Elementary Lesions of Inflammation

  • Gavino Faa
  • Daniela Fanni
  • Maria Leo
  • Karel Geboes


A diagnosis of the etiology or the type of colitis is usually not based upon a single discriminatory feature but rather upon a combination of “multiple” microscopic features. These should ideally be evidence based and reproducible and have good specificity and sensitivity. Genuine inflammation of the colonic (and small intestinal) mucosa is characterized by changes in the epithelial and lamina propria cell compartments. Both types of changes should be present. Alterations of the epithelial cells can be subdivided in changes of surface epithelial cells, crypt and surface architectural changes, and metaplasia. Typically there is a change of height of lining epithelial cells. In normal mucosa the surface epithelial height exceeds the height of crypt epithelium. The changes occurring in the lamina propria are not a reaction that develops from a zero baseline of leukocytes. Essentially, these changes are characterized by an increase in total cellularity, a more or less prominent redistribution of the infiltrating cells so that the infiltrate may or may not have a similar density throughout the lamina propria, including the basal part and changes in composition. A good understanding of the different lesions characteristic of inflammation will improve the diagnostic results.


Architectural change Crypt branching Crypt distortion Mucosal atrophy Crypt atrophy Crypt regeneration Cytokine Magnifying endoscopy Surface irregularity Tenascin Erosion Ulceration Restitution Pyloric gland metaplasia Metaplasia Ulcer-associated cell lineage Mucin depletion Apoptosis Paneth cell metaplasia Lamina propria cellularity Eosinophils Granuloma Lamina propria Basal plasmacytosis Eosinophilic colitis Allergic colitis Emperipolesis Epithelioid cell Basement membrane Collagenous colitis 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Gavino Faa
    • 1
  • Daniela Fanni
    • 1
  • Maria Leo
    • 1
  • Karel Geboes
    • 2
    • 3
  1. 1.Division of Pathology, Department of Surgical SciencesUniversity Hospital San Giovanni di Dio, University of CagliariCagliariItaly
  2. 2.Department of PathologyGhent University HospitalGhentBelgium
  3. 3.Department of PathologyKU LeuvenLeuvenBelgium

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