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Microscopic colitis: pathologic considerations, changing dogma.

Marie E Robert1

  • 1Department of Pathology, Yale University School of Medicine, 310 Cedar Street, PO Box 208023, New Haven, CT 06520, USA. marie.robert@yale.edu

Journal of Clinical Gastroenterology
|April 30, 2004
PubMed
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Microscopic colitis, a common finding in colonic biopsies, includes lymphocytic and collagenous types. This review details their pathology, pathogenesis, and differential diagnosis, highlighting evolving concepts in inflammatory bowel disease.

Area of Science:

  • Gastroenterology
  • Pathology

Background:

  • Microscopic colitis, recognized in 1976, is frequently evaluated in colonic mucosal biopsies.
  • It represents a significant diagnostic consideration in pathology practices, with up to 30% of biopsies addressing this condition.

Purpose of the Study:

  • To review the evolution of terminology and early pathology studies of microscopic colitis.
  • To detail the pathology, pathogenesis, and diagnostic pitfalls of lymphocytic and collagenous colitis.
  • To discuss the differential diagnosis, including inflammatory bowel diseases, infections, and drug reactions.

Main Methods:

  • Review of historical literature and early studies on microscopic colitis.
  • Detailed examination of histopathologic features of lymphocytic and collagenous colitis.

Related Experiment Videos

  • Analysis of differential diagnostic criteria and challenges.

    • Main Results:

    • The review covers the historical context and pathological characteristics of microscopic colitis subtypes.
    • It addresses common diagnostic challenges and current understanding of pathogenesis.
    • Recent findings suggest new histopathologic changes that may alter current classifications.

    Conclusions:

    • Microscopic colitis encompasses distinct entities like lymphocytic and collagenous colitis.
    • Accurate diagnosis requires careful histopathologic evaluation and consideration of differential diagnoses.
    • Emerging research challenges existing frameworks for understanding microscopic colitis within the spectrum of inflammatory bowel diseases.