Does lymphocytic colitis always present with normal endoscopic findings?

Area of Science:

• Gastroenterology
• Endoscopy
• Histopathology

Background:

• Microscopic colitis, specifically lymphocytic colitis (LC), typically presents with normal endoscopic findings.
• While macroscopic lesions (MLs) are documented in collagenous colitis, their occurrence in LC is less common.
• This study investigates the characteristics of LC with MLs.

Purpose of the Study:

• To explore the endoscopic, clinical, and histopathologic features of lymphocytic colitis (LC) when macroscopic lesions (MLs) are present.
• To determine if MLs alter the typical presentation of LC.

Main Methods:

• Retrospective analysis of 14 patients diagnosed with LC between 2005 and 2010.
• Comparison of endoscopic, clinical, and histopathologic findings based on the presence or absence of MLs.

Main Results:

• Macroscopic lesions (MLs) were identified in 7 out of 14 LC cases.
• MLs frequently exhibited hypervascularity (6 cases) and exudative bleeding (3 cases).
• Patients with MLs reported more severe diarrhea and were more likely to be taking aspirin or proton pump inhibitors.

Conclusions:

• Lymphocytic colitis (LC) can present with macroscopic lesions (MLs), challenging the assumption of normal endoscopic findings.
• Hypervascularity and exudative bleeding are common endoscopic observations in LC patients with MLs.