Document Detail


Pitfalls in the diagnosis of collagenous colitis: experience with 75 cases from a registry of collagenous colitis at the Johns Hopkins Hospital.
MedLine Citation:
PMID:  2394435     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Collagenous colitis is a relatively rare disorder presenting mainly in middle-aged women as watery diarrhea. Endoscopic and radiographic studies of the colon are usually normal, and diagnosis must be made by biopsy. The characteristic biopsy findings are a combination of increased mucosal inflammation (collagenous colitis) as well as subepithelial collagenous thickening. The mucosal inflammatory changes include increased lamina propria plasma cells, prominent intraepithelial lymphocytes, and in some cases, numerous eosinophils. The collagenous thickening has qualitative as well as quantitative differences from normal, and may be highlighted by Masson trichrome stains. Simply quantitating the thickness of a subepithelial collagen layer is neither adequate nor necessary for the diagnosis of collagenous colitis. Major problems in diagnosing collagenous colitis arise from focusing solely on the subepithelial region without attention to inflammatory changes. For example, tangential sectioning of normal colon results in an artifactually thickened basement membrane, and such cases have been wrongly interpreted as collagenous colitis. If biopsies lack the characteristic inflammatory pattern, a tangentially cut thick basement membrane should be ignored. The key to correct diagnosis of collagenous colitis is analyzing the summation of various inflammatory changes plus subepithelial collagenization, rather than focusing on any single feature in isolation.
Authors:
A J Lazenby; J H Yardley; F M Giardiello; T M Bayless
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Human pathology     Volume:  21     ISSN:  0046-8177     ISO Abbreviation:  Hum. Pathol.     Publication Date:  1990 Sep 
Date Detail:
Created Date:  1990-10-11     Completed Date:  1990-10-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9421547     Medline TA:  Hum Pathol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  905-10     Citation Subset:  IM    
Affiliation:
Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD.
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MeSH Terms
Descriptor/Qualifier:
Colitis / diagnosis,  metabolism,  pathology*
Collagen / metabolism*
Colon / pathology
Diagnostic Errors
Humans
Intestinal Mucosa / pathology
Terminology as Topic
Chemical
Reg. No./Substance:
9007-34-5/Collagen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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