Book contents
- Non-Neoplastic Pathology of the Gastrointestinal Tract
- Non-Neoplastic Pathology of the Gastrointestinal Tract
- Copyright page
- Dedication
- Contents
- Preface
- Acknowledgements
- Contributors
- Chapter 1 The Value of Gastrointestinal Biopsy
- Chapter 2 Gastrointestinal Involvement by Systemic Disease
- Chapter 3 Radiation and the Gastrointestinal Tract
- Chapter 4 Transplantation, Immunodeficiency, and Immunosuppression
- Chapter 5 Drug-Induced Gastrointestinal Disease
- Chapter 6 Gastrointestinal Ischemia and Vascular Disorders
- Chapter 7 Paediatric Conditions
- Chapter 8 Gastrointestinal Dysplasia
- Chapter 9 Normal Oesophageal, Gastric and Duodenal Mucosa
- Chapter 10 Histology of Gastroesophageal Reflux Disease and Barrett’s Oesophagus
- Chapter 11 Infections of the Oesophagus and Rare Forms of Oesophagitis
- Chapter 12 Assessment of Gastric Biopsies
- Chapter 13 Types of Gastritis
- Chapter 14 Duodenitis
- Chapter 15 Coeliac Disease
- Chapter 16 Inflammatory Bowel Disease and the Upper Gastrointestinal Tract
- Chapter 17 Normal Lower Gastrointestinal Mucosa
- Chapter 18 Infectious Disorders of the Lower Gastrointestinal Tract
- Chapter 19 Jejunitis and Ileitis
- Chapter 20 Microscopic Colitis
- Chapter 21 Inflammatory Bowel Disease Diagnosis
- Chapter 22 Mimics of Inflammatory Bowel Disease
- Chapter 23 Complications of Inflammatory Bowel Disease
- Chapter 24 Approach to Reporting Inflammatory Bowel Disease Biopsies
- Chapter 25 Ileal Pouch Anal Anastomosis
- Chapter 26 Diverticular Disease, Mucosal Prolapse, and Related Conditions
- Chapter 27 Non-Neoplastic Diseases of the Anal Canal
- Index
- References
Chapter 21 - Inflammatory Bowel Disease Diagnosis
Published online by Cambridge University Press: 06 June 2020
- Non-Neoplastic Pathology of the Gastrointestinal Tract
- Non-Neoplastic Pathology of the Gastrointestinal Tract
- Copyright page
- Dedication
- Contents
- Preface
- Acknowledgements
- Contributors
- Chapter 1 The Value of Gastrointestinal Biopsy
- Chapter 2 Gastrointestinal Involvement by Systemic Disease
- Chapter 3 Radiation and the Gastrointestinal Tract
- Chapter 4 Transplantation, Immunodeficiency, and Immunosuppression
- Chapter 5 Drug-Induced Gastrointestinal Disease
- Chapter 6 Gastrointestinal Ischemia and Vascular Disorders
- Chapter 7 Paediatric Conditions
- Chapter 8 Gastrointestinal Dysplasia
- Chapter 9 Normal Oesophageal, Gastric and Duodenal Mucosa
- Chapter 10 Histology of Gastroesophageal Reflux Disease and Barrett’s Oesophagus
- Chapter 11 Infections of the Oesophagus and Rare Forms of Oesophagitis
- Chapter 12 Assessment of Gastric Biopsies
- Chapter 13 Types of Gastritis
- Chapter 14 Duodenitis
- Chapter 15 Coeliac Disease
- Chapter 16 Inflammatory Bowel Disease and the Upper Gastrointestinal Tract
- Chapter 17 Normal Lower Gastrointestinal Mucosa
- Chapter 18 Infectious Disorders of the Lower Gastrointestinal Tract
- Chapter 19 Jejunitis and Ileitis
- Chapter 20 Microscopic Colitis
- Chapter 21 Inflammatory Bowel Disease Diagnosis
- Chapter 22 Mimics of Inflammatory Bowel Disease
- Chapter 23 Complications of Inflammatory Bowel Disease
- Chapter 24 Approach to Reporting Inflammatory Bowel Disease Biopsies
- Chapter 25 Ileal Pouch Anal Anastomosis
- Chapter 26 Diverticular Disease, Mucosal Prolapse, and Related Conditions
- Chapter 27 Non-Neoplastic Diseases of the Anal Canal
- Index
- References
Summary
Biopsy assessment of chronic idiopathic inflammatory bowel disease (IBD) is important for diagnosis, classification, determination of activity, documentation of anatomical extent and distribution, detection of complications, and diagnosis and grading of dysplasia. In addition, it may predict treatment response, clinical behaviour after therapy, and risk of future dysplasia. Microscopic features favouring IBD over non-IBD in biopsies include basal plasmacytosis and crypt architectural changes. Typically, ulcerative colitis (UC) extends from the rectum proximally and in a continuous fashion, while Crohn’s disease is discontinuous with intervening areas of sparing. Microscopic features that distinguish most reliably between Crohn’s disease and UC include granulomas (strongly favouring Crohn’s disease) and the distribution of architectural abnormalities/chronic inflammation between sites and within sites. However, discontinuity may also occur in UC. A caecal ‘patch’, i.e. a discontinuous area of caecal inflammation, is common in UC. Rectal sparing and other forms of discontinuity are more frequent in longstanding UC than new UC. The label IBD unclassified (IBDU) is available for difficult cases. In very early IBD (i.e., symptoms for <6 weeks), the architectural changes are often absent. IBD is common in patients with primary sclerosing cholangitis but may have unusual features. In summary, histological assessment in the light of the clinical and endoscopic findings plays an important role in optimising management of IBD.
Keywords
- Type
- Chapter
- Information
- Non-Neoplastic Pathology of the Gastrointestinal TractA Practical Guide to Biopsy Diagnosis, pp. 325 - 356Publisher: Cambridge University PressPrint publication year: 2020
References
- 1
- Cited by