The Clinical Significance of Incidental Chronic Colitis: A Study of 17 Cases

DSpace/Manakin Repository

The Clinical Significance of Incidental Chronic Colitis: A Study of 17 Cases

Citable link to this page


Title: The Clinical Significance of Incidental Chronic Colitis: A Study of 17 Cases
Author: Deshpande, Vikram; Hsu, MayLee; Kumarasinghe, M. Priyanthi; Lauwers, Gregory Y.

Note: Order does not necessarily reflect citation order of authors.

Citation: Deshpande, Vikram, MayLee Hsu, M. Priyanthi Kumarasinghe, and Gregory Y. Lauwers. 2010. “The Clinical Significance of Incidental Chronic Colitis: A Study of 17 Cases.” The American Journal of Surgical Pathology 34 (4) (April): 463–469. doi:10.1097/pas.0b013e3181d0fd76.
Access Status: Full text of the requested work is not available in DASH at this time (“dark deposit”). For more information on dark deposits, see our FAQ.
Full Text & Related Files:
Abstract: Introduction: A histologic diagnosis of chronic colitis raises a relatively limited differential diagnosis that includes inflammatory bowel disease, long-standing infections, and chronic ischemia. In routine clinical practice, inflammatory bowel disease accounts for the majority of cases of chronic colitis. Although a variety of drug-induced injury patterns in the colon have been recognized, there are few well-documented examples of drug-induced chronic colitis. In this study, we report the clinical, histologic, and follow-up data on 17 cases of histologically documented cases of chronic colitis in which a definitive etiologic factor could not be identified. Methods: Using our electronic databases we recorded all cases of chronic colitis in adults over an 8-year period. Patients with a history (prior or subsequent) of inflammatory bowel disease were excluded. Cases showing histologic features of ischemic, pseudomembranous, or granulomatous colitis were excluded. The biopsies were evaluated and semiquantitatively scored for established histologic features of activity and chronicity. The clinical, endoscopic, and follow-up data, including drug usage, was recorded. Results: There were 10 males and 7 females and the mean age was 59 years. The majority of cases involved the cecum or ascending colon (16 of 17 cases). A majority of patients were asymptomatic (n=11), and in others, indications for colonoscopy were occult blood (n=3), hematochezia (n=2), and melena (n=1). The most common mucosal abnormality was erythema (n=10), ulcers (n=3), congestion (n=3), and edematous mucosa (n=1). All cases showed histologic features of chronicity and showed either basal plasmacytosis (94%) or crypt architectural distortion (94%). Eight (47%) patients reported nonsteroidal anti-inflammatory drugs (NSAID) use. Withdrawal of NSAIDs in 2 cases resulted in normalization of the colonic mucosa. On follow-up, all 17 patients were asymptomatic (median follow-up 42.8 mo) and did not progress to inflammatory bowel disease. Conclusions: We report a series of 17 histologically documented cases of incidental chronic colitis without a conventional etiology. However, both the frequent usage of NSAIDs, and normalization of mucosal changes after withdrawal of this drug suggest that NSAIDs may account for this cecal-based chronic colitis. The awareness of this histologically dramatic but clinically innocuous form of chronic colitis may avoid errors in mucosal biopsy diagnosis.
Published Version: doi:10.1097/PAS.0b013e3181d0fd76
Citable link to this page:
Downloads of this work:

Show full Dublin Core record

This item appears in the following Collection(s)


Search DASH

Advanced Search