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Review
. 2021 Feb;113(1):39-53.
doi: 10.32074/1591-951X-235.

Histopathology of IBD Colitis. A practical approach from the pathologists of the Italian Group for the study of the gastrointestinal tract (GIPAD)

Vincenzo Villanacci  1 , Luca Reggiani-Bonetti  2 , Tiziana Salviato  2 , Giuseppe Leoncini  3 , Moris Cadei  1 , Luca Albarello  4 , Alessandro Caputo  5 , Maria Costanza Aquilano  6 , Serena Battista  7 , Paola Parente  8
Affiliations
Review

Histopathology of IBD Colitis. A practical approach from the pathologists of the Italian Group for the study of the gastrointestinal tract (GIPAD)

Vincenzo Villanacci et al. Pathologica. 2021 Feb.

Abstract

Inflammatory bowel diseases (IBDs) are lifelong disorders in which an interaction between genetic and environmental factors is involved. IBDs include two entities: Crohn's disease (CD) and ulcerative colitis (UC); these can be adequately diagnosed and distinguished with a correct methodological approach based on communicating exhaustive clinical, endoscopic and laboratory information to the pathologist and performing adequate bioptic sampling and precise morphological signs including crypt architecture, distribution of inflammation and granulomas, when present. IBD needs to be distinguished from non-IBD colitis, mostly at its onset. Moreover, IBDs are associated with an increased risk of developing colorectal adenocarcinoma. In daily pathological practice, correct diagnosis of IBD and its subclassification as well as a correct detection of dysplasia is imperative to establish the best therapeutic approach.

Keywords: Crohn’s disease; dysplasia; inflammatory bowel disease; intestinal cancer; ulcerative colitis.

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Conflict of interest statement

Conflict of interest

The Authors declare no conflict of interest.

Figures

Figure 1.
Figure 1.
(A, B, C) Ulcerative colitis with moderate-severe activity. (D) Basal plasmocytosis with plasma cells and eosinophils (arrows). H&E A-B: 4x, C: 20x, D: 60x. (E, F, G, H) Ulcerative colitis in remission (quiescence of disease) H&E E: 10x, F-G-H: 20x. (I, L, M, N) Ulcerative colitis: surgical specimen with inflammation located in the mucosa. H&E I-L: 4x, M-N: 20x.
Figure 2.
Figure 2.
Crohn’s disease. (A) Patchy inflammation, (B-C) granuloma, (D) granuloma. H&E A-B: 20x, C: 40x, D: 60x. (E, F, G, H) Crohn’s disease surgical specimen, inflammation penetrating the different layers of the terminal ileum H&E E: 4x, F: 10x, G: 20x, H: 40x. (I, L, M, N) Early Crohn’s disease, focal superficial inflammation in the terminal ileum. H&E I: 10x, L: 40x, M: 20x; N 40x.
Figure 3.
Figure 3.
Dysplasia in IBD. (A, B, C, D) Low grade dysplasia A-B-C H&E A: 10x, B: 20x, C: 40x; D: immunostain for P53 20x. (E, F, G, H) High grade dysplasia E-F-G H&E E: 10x, F-G: 40x; H: immunostain for P53 40x.
See this image and copyright information in PMC

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