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Clinical Implications of Microscopic Colitis Isolated to Polyps.
Caroline Miller1, Christa Whitney-Miller1, Mark G Ettel1
1Department of Pathology, University of Rochester Medical Center, Rochester, NY, USA.
International Journal of Surgical Pathology
|July 10, 2023
Summary
Polypoid microscopic colitis, found incidentally in polyps, may lead to chronic diarrhea or microscopic colitis in some patients. Pathologists should differentiate it from conventional microscopic colitis for appropriate clinical follow-up.
Area of Science:
- Gastroenterology
- Pathology
Background:
- Microscopic colitis (MC) is typically diagnosed via random colon biopsies for chronic diarrhea.
- Rarely, polyps can exhibit histologic features of MC, termed polypoid microscopic colitis (PMC).
Purpose of the Study:
- To compare patients with PMC to controls with conventional polyps.
- To determine the clinical implications and outcomes associated with PMC.
Main Methods:
- Retrospective search of medical records for patients with PMC.
- Selection of control patients with conventional polyps.
- Review of histologic, endoscopic, and clinical data for both groups.
Main Results:
- Twenty-six PMC cases were identified; 69% were lymphocytic colitis, 31% collagenous colitis.
- PMC patients were older than controls (median age 60 vs 66 years).
- Follow-up showed 33% of PMC patients developed chronic diarrhea versus 12% of controls; 13% developed MC versus 0% of controls.
Conclusions:
- PMC can occur in asymptomatic individuals and often does not lead to chronic diarrhea.
- However, a subset of PMC patients may develop chronic diarrhea or conventional MC on follow-up.
- Distinguishing PMC from conventional MC is crucial for guiding clinical management and follow-up decisions.
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