Diagnostic dilemmas in chronic inflammatory bowel disease.

Histopathological assessment of biopsy and resection specimens of chronic inflammatory bowel disease (CIBD), or possible CIBD, forms a significant component of the routine workload in most tissue pathology laboratories. In this review, we have chosen selected areas of particular diagnostic difficult...

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Publicado en:Virchows Archiv: European Journal of Pathology Vol. 472; no. 1; pp. 81 - 98
Autores principales: Loughrey, Maurice B., Shepherd, Neil A.
Formato: pictorial review tables/charts Journal Article
Publicado: Springer Nature Jan2018
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
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        atl: Diagnostic dilemmas in chronic inflammatory bowel disease.
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        au:
          Loughrey, Maurice B.
          Shepherd, Neil A.
        affil: Department of Histopathology, Royal Victoria Hospital, Grosvenor Road, BT12 6BA, Belfast, Northern Ireland, UK
      sug:
        subj:
          Inflammatory Bowel Diseases Diagnosis
          Chronic Disease
      ab: Histopathological assessment of biopsy and resection specimens of chronic inflammatory bowel disease (CIBD), or possible CIBD, forms a significant component of the routine workload in most tissue pathology laboratories. In this review, we have chosen selected areas of particular diagnostic difficulty in CIBD pathology, providing key advice for pathology reporting. Those mimics of CIBD which have the greatest potential for misdiagnosis are discussed, particularly the wide range of infectious colitides which represent possible diagnostic pitfalls. The most important distinguishing features between the two main forms of CIBD, ulcerative colitis and Crohn's disease, are addressed, first in relation to resection specimens, and then with emphasis on features which may also be diagnostically useful in endoscopic biopsy material. The importance of assessment of the index endoscopic specimen is stressed, before treatment has been instigated, along with careful correlation with clinical and endoscopic features. Problems in the assessment of post-surgical CIBD specimens are described and then the role of upper gastrointestinal pathology specimens in diagnosing both Crohn's disease and ulcerative colitis, with increased recognition of upper gastrointestinal tract involvement in the latter condition. Finally, with recent developments in endoscopic surveillance techniques and local excision options, modern approaches to reporting and managing neoplasia complicating CIBD are reviewed.
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    language: English
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