Document Detail


Lymphocytic Follicles and Aggregates Are a Determinant of Mucosal Damage and Duration of Diarrhea.
MedLine Citation:
PMID:  23276179     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Context.-Nonspecific changes (nonspecific chronic inflammation) in patients with chronic diarrhea represent the commonest diagnosis in colorectal biopsy interpretation, but these changes are of little clinical significance. Objective.-To find, within this group, histologic and immunohistologic diagnostic criteria to predict the duration and resolution of diarrhea. Design.-Detailed clinical features and histologic findings were analyzed in a cohort of 47 patients with chronic diarrhea, with near-normal histology and no clear-cut known etiologic agent. Immunohistochemistry to mast cells (CD117) and Treg cells (FOXP3) was also assessed in 39 patients. Results.-Increased number of lymphoid follicles and aggregates, increased number of mast cells, and paucity of Treg were the statistically significant key findings (P  =  .003, P  =  .008, and P  =  .04, respectively). The duration of diarrhea was correlated with the number of large lymphoid follicles and aggregates (P  =  .001, r  =  .48), number of total lymphoid follicles and aggregates (P  =  .003, r  =  .43), density of lymphoid follicles and aggregates (P  =  .009, r  =  .38), and total lymphoid follicles and aggregates per biopsy (P  =  .004, r  =  .42) and the number of mast cells (P  =  .001, r  =  .52). The number of mast cells and Treg cells showed significant difference between resolved and unresolved cases (P  =  .001 and P  =  .01 respectively). Conclusions.-Lymphocytic follicles and aggregates colitis, previously regarded as of negligible diagnostic significance, allows the prediction of the behavior of chronic diarrhea in a subset of patients with nonspecific changes on colonic biopsy. The increased number of mast cells and paucity of Treg cells further helps to identify such unresolved cases.
Authors:
Nilesh Shah; Bhavin Thakkar; Emily Shen; Marie Loh; Pei Yi Chong; Wee Hoe Gan; Tian Ming Tu; Liang Shen; Richie Soong; Manuel Salto-Tellez
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Archives of pathology & laboratory medicine     Volume:  137     ISSN:  1543-2165     ISO Abbreviation:  Arch. Pathol. Lab. Med.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7607091     Medline TA:  Arch Pathol Lab Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  83-89     Citation Subset:  -    
Affiliation:
From the Cancer Science Institute of Singapore (Drs Shah, Thakkar, Soong, and Salto-Tellez, Ms Loh, and Ms Chong), the Department of Pathology, National University Hospital, Yong Loo Lin Medical School (Drs Soong and Salto-Tellez), and the Biostatistics Unit, Yong Loo Lin Medical School (Dr L. Shen), National University of Singapore, Singapore; the Endoscopy Centre (Gastroenterology), Tan Tock Seng Hospital, Singapore (Dr E. Shen, Dr Gan, and Dr Tu); and the Centre for Cancer Research and Cell Biology, Queen's University, Belfast, United Kingdom (Dr Salto-Tellez).
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