Lymphocytic ("microscopic") colitis

A comparative histopathologic study with particular reference to collagenous colitis

Audrey J Lazenby, John H. Yardley, Francis M. Giardiello, Jose Jessurun, Theodore M. Bayless

Research output: Contribution to journalArticle

380 Citations (Scopus)

Abstract

Lymphocytic colitis, previously termed "microscopic colitis", is a clinicopathologic syndrome of watery diarrhea, grossly normal colonoscopy, and mucosal inflammatory changes. Since lymphocytic colitis is a new, incompletely characterized entity, a histopathologic study was performed to compare lymphocytic colitis (n = 16), collagenous colitis (n = 17), idiopathic inflammatory bowel disease (n = 16), acute colitis (n = 16), and histologically normal colon (n = 12). The study was a blinded semiquantitative analysis of histologic features in the surface epithelium, lamina propria, and crypts. The most distinctive feature of lymphocytic colitis was increased intraepithelial lymphocytes, particularly in the surface epithelium (P = .0001 v idiopathic inflammatory bowel disease, acute colitis, and normal colon). Other prominent features of lymphocytic colitis included surface epithelial damage (P < .005 v diopathic inflammatory bowel disease and normal colon), increased lamina propria chronic inflammation (P < .01 v normal), and minimal crypt distortion or active cryptitis. There were striking similarities between lymphocytic colitis and collagenous colitis, but subepithelial collagen thickening was seen only in collagenous colitis. Idiopathic inflammatory bowel disease showed prominent crypt distortion and greater active inflammation, in addition to minimal intraepithelial lymphocytes. Acute colitis occasionally demonstrated prominent surface epithelial damage, but was otherwise dissimilar from lymphocytic colitis. We reached the following conclusions: (1) the entity "microscopic colitis" shows characteristic histopathology including prominent lymphocytic infiltration of epithelium, and thus, a more appropriate designation is lymphocytic colitis; (2) although lymphocytic colitis closely resembles collagenous colitis, each entity is distinct on biopsy; and (3) lymphocytic colitis is readily distinguishable from idiopathic inflammatory bowel disease, acute forms of colitis, and normal colorectum.

Original languageEnglish (US)
Pages (from-to)18-28
Number of pages11
JournalHuman Pathology
Volume20
Issue number1
DOIs
StatePublished - Jan 1 1989

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Lymphocytic Colitis
Microscopic Colitis
Collagenous Colitis
Colitis
Inflammatory Bowel Diseases
Colon
Epithelium
Mucous Membrane
Vipoma
Lymphocytes
Inflammation
Colonoscopy

Keywords

  • collagenous colitis
  • lymphocytic ("microscopic") colitis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Lymphocytic ("microscopic") colitis : A comparative histopathologic study with particular reference to collagenous colitis. / Lazenby, Audrey J; Yardley, John H.; Giardiello, Francis M.; Jessurun, Jose; Bayless, Theodore M.

In: Human Pathology, Vol. 20, No. 1, 01.01.1989, p. 18-28.

Research output: Contribution to journalArticle

Lazenby, Audrey J ; Yardley, John H. ; Giardiello, Francis M. ; Jessurun, Jose ; Bayless, Theodore M. / Lymphocytic ("microscopic") colitis : A comparative histopathologic study with particular reference to collagenous colitis. In: Human Pathology. 1989 ; Vol. 20, No. 1. pp. 18-28.
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