The histopathological approach to inflammatory bowel disease: a practice guide.

Inflammatory bowel diseases (IBDs) are lifelong disorders predominantly present in developed countries. In their pathogenesis, an interaction between genetic and environmental factors is involved. This practice guide, prepared on behalf of the European Society of Pathology and the European Crohn's a...

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Publicado en:Virchows Archiv: European Journal of Pathology Vol. 464; no. 5; pp. 511 - 528
Autores principales: Langner, Cord, Magro, Fernando, Driessen, Ann, Ensari, Arzu, Mantzaris, Gerassimos J, Villanacci, Vincenzo, Becheanu, Gabriel, Borralho Nunes, Paula, Cathomas, Gieri, Fries, Walter, Jouret-Mourin, Anne, Mescoli, Claudia, de Petris, Giovanni, Rubio, Carlos A, Shepherd, Neil A, Vieth, Michael, Eliakim, Rami, Geboes, Karel
Formato: practice guidelines Journal Article
Publicado: Springer Nature May2014
Acceso en línea:Ver este registro en EBSCOhost
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          Langner, Cord
          Magro, Fernando
          Driessen, Ann
          Ensari, Arzu
          Mantzaris, Gerassimos J
          Villanacci, Vincenzo
          Becheanu, Gabriel
          Borralho Nunes, Paula
          Cathomas, Gieri
          Fries, Walter
          Jouret-Mourin, Anne
          Mescoli, Claudia
          de Petris, Giovanni
          Rubio, Carlos A
          Shepherd, Neil A
          Vieth, Michael
          Eliakim, Rami
          Geboes, Karel
        affil: Institute of Pathology, Medical University of Graz, Auenbruggerplatz 25, 8036, Graz, Austria, cord.langner@medunigraz.at.
      sug:
        subj: Inflammatory Bowel Diseases Diagnosis
      ab: Inflammatory bowel diseases (IBDs) are lifelong disorders predominantly present in developed countries. In their pathogenesis, an interaction between genetic and environmental factors is involved. This practice guide, prepared on behalf of the European Society of Pathology and the European Crohn's and Colitis Organisation, intends to provide a thorough basis for the histological evaluation of resection specimens and biopsy samples from patients with ulcerative colitis or Crohn's disease. Histopathologically, these diseases are characterised by the extent and the distribution of mucosal architectural abnormality, the cellularity of the lamina propria and the cell types present, but these features frequently overlap. If a definitive diagnosis is not possible, the term indeterminate colitis is used for resection specimens and the term inflammatory bowel disease unclassified for biopsies. Activity of disease is reflected by neutrophil granulocyte infiltration and epithelial damage. The evolution of the histological features that are useful for diagnosis is time- and disease-activity dependent: early disease and long-standing disease show different microscopic aspects. Likewise, the histopathology of childhood-onset IBD is distinctly different from adult-onset IBD. In the differential diagnosis of severe colitis refractory to immunosuppressive therapy, reactivation of latent cytomegalovirus (CMV) infection should be considered and CMV should be tested for in all patients. Finally, patients with longstanding IBD have an increased risk for the development of adenocarcinoma. Dysplasia is the universally used marker of an increased cancer risk, but inter-observer agreement is poor for the categories low-grade dysplasia and indefinite for dysplasia. A diagnosis of dysplasia should not be made by a single pathologist but needs to be confirmed by a pathologist with expertise in gastrointestinal pathology.
      pubtype: Academic Journal
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    language: English
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