scholarly journals Audit of the histopathological diagnosis of non-neoplastic colorectal biopsies: achievable standards for the diagnosis of inflammatory bowel disease

1998 ◽  
Vol 51 (5) ◽  
pp. 378-381 ◽  
Author(s):  
A. K. Dube ◽  
S. S. Cross ◽  
A. J. Lobo
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Histopathological Diagnosis ◽  
Colorectal Biopsies ◽  
Inflammatory Bowel

scholarly journals Utility of Colonoscopic Biopsies in Histomorphological Spectrum of Colorectal Lesions - A Study in a Tertiary Care Centre in Aurangabad Region of Maharashtra

2021 ◽  
Vol 8 (23) ◽  
pp. 1909-1914
Author(s):  
Suparna Sharad Pingle
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Tertiary Care ◽  
Histopathological Diagnosis ◽  
Chronic Colitis ◽  
Female Ratio ◽  
Study Results ◽  
Neoplastic Lesions ◽  
Colorectal Biopsies ◽  
Inflammatory Bowel

BACKGROUND Colonoscopy is considered as a diagnostic procedure of choice for patients presenting with chronic diarrhoea / bloody diarrhoea. Colonoscopic mucosal biopsies have shown to be accurate indicators of extent of the involvement of colon in inflammatory bowel disease. Also, colonoscopy is still considered as the gold standard in cancer surveillance. The present study was undertaken to find out the utility of colonoscopic biopsies in histomorphological spectrum of colorectal lesions. METHODS This was a three-year retrospective study carried out in the Department of Pathology, at MGM Medical College, Aurangabad. Patient’s clinical details, colonoscopic findings and apparent pathology were noted in 206 cases along with final histopathological diagnosis. Biopsies which showed significant findings were included in the study. RESULTS In the study, the male to female ratio was 2.4 : 1. Out of 206 colorectal biopsies, 146 (70.8 %) were non-neoplastic and 60 (29.2 %) were neoplastic lesions. Amongst non-neoplastic lesions, maximum cases were of chronic colitis with 4 cases of granulomatous colitis and 30 cases of inflammatory bowel disease. Adenocarcinoma was the most common histologic type in neoplastic lesions (66.6 %), with rectum being the most common site followed by colonic polyps (25 %). As far as age group was concerned, the 2nd decade was dominated by chronic colitis, 3rd decade by adenomatous polyps and 5th decade by adenocarcinoma. CONCLUSIONS Histomorphological profile of colorectal biopsies has a wide spectrum ranging from infectious diseases, inflammatory bowel disorders to colorectal malignancies. Histopathology with correlation of clinical and endoscopic findings plays a major role in accurate diagnosis of colorectal lesions. KEYWORDS Colonoscopy, Biopsies, Neoplastic, Non-Neoplastic, Colitis, Adenocarcinoma

scholarly journals Pathology of Inflammatory Bowel Disease

2015 ◽  
Vol 5 (9) ◽  
pp. 756-765
Author(s):  
Shiva Raj K.C.
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Gold Standard ◽  
Genetic Factors ◽  
Clinical Laboratory ◽  
Mucosal Immune Response ◽  
Unknown Etiology ◽  
Histopathological Diagnosis ◽  
Bowel Diseases ◽  
Inflammatory Bowel

Inflammatory bowel disease is a group of inflammatory disorders of unknown etiology. Various genetic factors, mucosal immune response, inappropriate activation of immune system driven by the presence of various luminal flora and epithelial defects have been postulated. Crohn disease and Ulcerative colitis are the two most common inflammatory bowel diseases. Since, specific clinical laboratory features are lacking which may help in establishing a diagnosis histopathological diagnosis remains the gold standard. This review highlights the known hypothesis regarding the etiopathogenesis of these two diseases and also describes pertinent histological features.Journal of Pathology of Nepal (2015) Vol. 5, 756-765

scholarly journals Inflammatory bowel disease biopsies: updated British Society of Gastroenterology reporting guidelines

2013 ◽  
Vol 66 (12) ◽  
pp. 1005-1026 ◽  
Author(s):  
Roger M Feakins
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
British Society ◽  
Histopathological Diagnosis ◽  
Anatomical Distribution ◽  
Biopsy Report ◽  
Inflammatory Bowel ◽  
Diverticular Colitis

Accurate histopathological assessment of biopsies is important for the diagnosis, subclassification, and management of chronic idiopathic inflammatory bowel disease (IBD). British Society of Gastroenterology (BSG) guidelines for the initial histopathological diagnosis of IBD were published in 1997. Changes since then include: more widespread use of full colonoscopy; greater recognition of the effects of time and treatment; improved documentation of variations in anatomical distribution; better understanding of the mimics of IBD; significant progress in clinical management; and modifications of terminology. Accordingly, an update is required. These revised guidelines aim to optimise the quality and consistency of reporting of biopsies taken for the initial diagnosis of IBD by summarising the literature and making recommendations based on the available evidence. Advice from existing clinical guidelines is also taken into account. Among the subjects discussed are: distinguishing IBD from other colitides, particularly infective colitis; subclassification of IBD (as ulcerative colitis, Crohn's disease, or IBD unclassified); the discriminant value of granulomas; aspects of disease distribution, including discontinuity in ulcerative colitis; time-related changes; differences between paediatric and adult IBD; the role of ileal and upper gastrointestinal biopsies; differential diagnoses such as diverticular colitis and diversion proctocolitis; and dysplasia. The need to correlate the histological features with clinical and endoscopic findings is emphasised. An approach to the conclusion of an IBD biopsy report based on the acronym Pattern, Activity, Interpretation, Dysplasia (PAID) is suggested. The key recommendations are listed at the end of the document.

Histopathological Mimics of Inflammatory Bowel Disease

2019 ◽  
Vol 26 (7) ◽  
pp. 994-1009 ◽  
Author(s):  
John B Schofield ◽  
Najib Haboubi
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Clinical History ◽  
Review Article ◽  
Accurate Diagnosis ◽  
Histopathological Diagnosis ◽  
Multidisciplinary Team Meeting ◽  
Foreign Travel ◽  
Drug History ◽  
Inflammatory Bowel

Abstract This review article discusses the challenges of making a firm histopathological diagnosis of inflammatory bowel disease (IBD) on biopsy and resection material and the importance of its distinction from a range of other inflammatory and infective conditions that may closely mimic IBD. In many cases, the diagnosis of ulcerative colitis or Crohn's disease is straightforward, especially when patients have a typical presentation and characteristic histopathological features. Knowledge of the full clinical history is very important, particularly past and recent medical history, drug history, foreign travel, or known contact with individuals with specific infection. Discussion of all cases of suspected IBD within a multidisciplinary team meeting is required to ensure that clinical, radiological, and pathological features can be correlated. Mimics of IBD can be divided into 4 categories: 1) those due to specific infection, 2) those due to a specific localized inflammatory process, 3) those due to iatrogenic causes, and 4) other rarer causes. Accurate diagnosis of IBD and exclusion of these mimics are crucial for patient management. Once a diagnosis of IBD has been proffered by a pathologist, it is very difficult to “undiagnose” the condition when an alternative diagnosis or “mimic” has been subsequently identified. The histological diagnosis of each of these IBD mimics is discussed in detail, with guidance on how to avoid the pitfall of missing these sometimes very subtle and “difficult to diagnose” conditions.

scholarly journals Specimen Adequacy and Clinicopathological Evaluation of Inflammatory Bowel Disease Colorectal Biopsies in Cipto Mangunkusumo Hospital Jakarta

2021 ◽  
Vol 22 (2) ◽  
pp. 100-105
Author(s):  
Lydia Kencana ◽  
Nur Rahadiani ◽  
Marini Stephanie ◽  
Diah Rini Handjari ◽  
Ening Krisnuhoni
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Active Phase ◽  
Clinical History ◽  
Daily Practice ◽  
Histological Evaluation ◽  
Cross Sectional ◽  
Gastrointestinal Pathology ◽  
Colorectal Biopsies ◽  
Inflammatory Bowel

Background: Colorectal mucosal biopsies account for majority of daily practice specimens in the field of gastrointestinal pathology. Most of them were sent for inflammatory bowel disease (IBD) evaluation. Due to broad spectrum of histologic findings and different stage of disease, pathologists often find difficulties on calling out diagnosis of IBD. This study aims to evaluate the adequacy of specimen, clinical characteristics, endoscopy and histologic findings of colorectal biopsies from IBD and non-IBD patients.Method: This cross-sectional study included 49 IBD and 49 non-IBD cases registered in the archives of Anatomical Pathology Department, Cipto Mangunkusumo National Referral Hospital Jakarta in 2019. The samples were evaluated for adequacy of specimen, clinical, endoscopy and histologic findings.Results: Most samples were adult with a slight female predominance. All request forms contained the clinical working diagnosis but only 26.5% and 20.4% of them provided clinical history and endoscopy findings. During histology evaluation, 59.2% of the specimen was considered sub-optimal. The most common histologic findings in both IBD and non-IBD groups were diffuse lymphoplasmacytic infiltration in the lamina propria and crypt distortion. Fibrosis/collagen deposition was found in 38.8% of IBD population compared to 12.2% of non-IBD population (p=0.003). Most IBD cases (55.1%) were categorized as active phase IBD.Conclusion: Since the most common histologic findings in IBD patients were also found in non-IBD patients, IBD diagnosis based on histopathology alone is highly inadvisable. However, there were also lack of clinical data and endoscopy findings in most of colorectal biopsies sent for IBD evaluation. Along with overlapping and unspecific morphology and suboptimal events during histological evaluation, all of this complicated the diagnosis of IBD. Hence multidisciplinary approach is required for a better IBD diagnosis and treatment.

scholarly journals Pitfalls in the Histological Diagnosis of Inflammatory Bowel Disease on Colorectal Biopsies

1990 ◽  
Vol 4 (7) ◽  
pp. 336-340
Author(s):  
DA Malatjalian
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Histopathological Examination ◽  
Chronic Inflammatory Bowel Disease ◽  
Accurate Identification ◽  
Biopsy Specimens ◽  
Colorectal Biopsies ◽  
Inflammatory Bowel ◽  
Characteristic Features ◽  
Chronic Inflammatory Bowel

Histopathological examination of appropriate colorectal biopsy specimens allows accurate identification of chronic inflammatory bowel disease in the majority of cases. Pitfalls, however, appear because overlapping histological features occur among the various forms of colitis or because a specific form of colitis may exhibit incomplete expression of its characteristic features. Pitfalls can be minimized if the histological findings are considered in the context of all other clinical and investigative data.

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