http://reference.medscape.com/medline/a ... src=nlbestClinical and pathological analysis of colonic Crohn's disease, including a subgroup with ulcerative colitis-like features.
Mod Pathol. 2012; 25(2):295-307 (ISSN: 1530-0285)
Soucy G; Wang HH; Farraye FA; Schmidt JF; Farris AB; Lauwers GY; Cerda SR; Dendrinos KG; Odze RD
Department of Pathology, Centre Hospitalier Universitaire de Montreal, Montreal, Quebec, Canada.
Little is known regarding the clinical and, in particular, pathological manifestations of patients with isolated colonic Crohn's disease. The purpose of this study was to evaluate the clinical and pathological features of patients with Crohn's disease limited to the colon at initial presentation, and to determine whether there are any histological features that are predictive of outcome after surgery. The clinical features, outcome after surgery, and pathological features of colonic resection specimens of 73 patients who presented initially with isolated colonic Crohn's disease were evaluated and compared with 45 Crohn's disease patients who presented initially with both ileal and colonic involvement. Clinically, patients with isolated colonic Crohn's disease presented at a significantly older age at the time of diagnosis, and had a significantly shorter duration of colitis before surgical resection, than did patients with ileocolonic Crohn's disease at disease onset. Pathologically, patients with isolated colonic Crohn's disease showed a significantly higher proportion of cases with subtotal, total, or left-sided colitis, and significantly fewer strictures/stenosis, pericolonic adhesions, pyloric metaplasia, and cases with proximal worse than distal colonic disease. Overall, patients with isolated colonic Crohn's disease showed a trend toward a lower number of major microscopic Crohn's disease features. A small proportion of patients from both Crohn's disease groups (14% and 13%, respectively) showed inflammatory disease limited to the mucosa, without mural involvement, reminiscent of ulcerative colitis, and these were termed 'ulcerative colitis-like Crohn's disease'. These patients were significantly younger than those with mural involvement. Overall, 44% of patients from both Crohn's disease groups developed at least one adverse outcome, and neither the number nor the type of major Crohn's disease features correlated with adverse outcome. Patients with isolated colonic involvement have distinctive clinical and pathological features. A small subgroup of Crohn's patients shows only mucosal involvement reminiscent of ulcerative colitis.
Uhh, "colonic Crohn's" sounds identical to MC!
Moderators: Rosie, Stanz, Jean, CAMary, moremuscle, JFR, Dee, xet, Peggy, Matthew, Gabes-Apg, grannyh, Gloria, Mars, starfire, Polly, Joefnh
Uhh, "colonic Crohn's" sounds identical to MC!
Am I crazy, or are they basically describing MC with their "isolated colonic Crohn's" description?? "Inflammatory disease limited to the mucosa, without mural involvement"?
Actually, to me they appear to be describing an overlap with UC, rather than MC. It's relatively easy to tell the difference between MC (LC) and Crohn's or UC. Crohn's and UC involve eosinophilic infiltration, whereas LC does not. Also, MC does not involve any changes to the crypts in the mucosa, whereas alterations in crypt architecture (such as atypical branching) are typically associated with Crohn's and UC. I didn't read the article, but the quote you listed doesn't mention any diagnostic markers -- instead it seems to dwell on the distribution characteristics.
Tex
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.