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Related Experiment Videos

Microscopic colitis with giant cells: a rare new histopathologic subtype?

D Sandmeier1, H Bouzourene

  • 1Institute of Pathology, Lausanne, Switzerland.

International Journal of Surgical Pathology
|February 7, 2004
PubMed
Summary

Microscopic colitis (MC) can present with unusual subepithelial giant cells, a rare finding in collagenous colitis (CC) and lymphocytic colitis (LC). This distinct subtype of MC shows favorable outcomes with corticosteroid treatment.

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Area of Science:

  • Gastroenterology
  • Pathology
  • Colorectal Diseases

Background:

  • Collagenous colitis (CC) and lymphocytic colitis (LC) are recognized subtypes of microscopic colitis (MC).
  • These conditions are often considered part of a shared disease spectrum.
  • The histopathological features of MC are typically confined to the colonic epithelium and superficial lamina propria.

Observation:

  • A rare histopathologic subtype of microscopic colitis (MC) is described, characterized by subepithelial multinucleated giant cells.
  • This unusual finding was observed in 2 out of 490 (0.4%) MC cases diagnosed between 1992 and 2002.
  • The giant cells were located in the superficial lamina propria, with one case each of LC and CC exhibiting this feature.

Findings:

  • Infectious and non-infectious granulomatous colonic diseases were excluded through comprehensive histologic, clinical, and biological assessments.

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  • The presence of multinucleated giant cells in MC is an uncommon finding, not attributable to other disease processes or treatments.
  • This specific histopathologic feature aids in differentiating MC from granulomatous conditions like Crohn's disease.

    • Implications:

    • Recognition of this giant cell-rich MC subtype is crucial for accurate diagnosis and to prevent misdiagnosis of other granulomatous colitis.
    • Despite its rarity, this MC variant demonstrates a positive prognosis.
    • Affected patients responded well to corticosteroid therapy, suggesting a potential treatment strategy.