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Corrupted Colonic Crypts Bordering Regenerating Mucosal Ulcers in Ulcerative Colitis.

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Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Pathology

Background:

  • Ulcerative colitis (UC) histology shows chronic inflammation and architectural distortion of colonic crypts.
  • The origin of these distorted crypts, termed corrupted colonic crypts (CCCs), remained unclear.
  • A review of colectomy specimens revealed CCCs surrounding mucosal ulcerations.

Purpose of the Study:

  • To investigate the histogenesis of corrupted colonic crypts (CCCs) in ulcerative colitis (UC).
  • To characterize the morphology of CCCs found adjacent to mucosal ulcers.
  • To determine if CCCs are specific to UC or associated with other colonic conditions.

Main Methods:

  • Analysis of hematoxylin and eosin (H&E)-stained sections from three colectomy specimens with mucosal ulcers.
  • Detailed examination of colonic mucosa bordering 60 identified ulcers.
  • Classification of various corrupted colonic crypt (CCC) phenotypes based on their morphology.

Main Results:

  • Sixty ulcers were identified across 49 sections from three colectomies.
  • Multiple phenotypes of corrupted colonic crypts (CCCs) were observed bordering these ulcers, including asymmetric fission, dual/three-foiled fission, cystic dilatations, L-shaped, T-inverted, shoe-shaped, horizontal, multi-lobate, and inter-connecting crypts.
  • CCCs were predominantly found near ulcers, with few or none in inflamed areas without ulcers, and were absent in other colonic diseases.

Conclusions:

  • Corrupted colonic crypts (CCCs) appear to form during the regeneration of ulcers in ulcerative colitis (UC).
  • The presence of CCCs is not solely due to chronic inflammation or non-specific ulcers.
  • The findings suggest that crypt distortions in non-ulcerated mucosa of UC patients may represent evidence of prior mucosal ulcerations.