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Does lymphocytic colitis always present with normal endoscopic findings?

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Summary

Macroscopic lesions (MLs) can occur in lymphocytic colitis (LC), contrary to typical endoscopic findings. These MLs, often showing hypervascularity and bleeding, are associated with more severe diarrhea.

Keywords:
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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.