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Biopsy Diagnosis of Non-IBD Colitis

LC affects adults of both genders equally. The etiologies are multiple. Most patients report an average of about 5 bowel movements a day and complain of mild, crampy abdominal pain. The mucosal architecture is preserved with no crypt distortion, and a dense lamina propria with moderate lymphoplasmacytic infiltrate is noted. Lymphocytic exocytosis is present in the crypts and on the surface epithelium, with evidence of epithelial damage. Excess of intraepithelial lymphocytes is defined by the presence of more than 15 lymphocytes per 100 surface epithelial cells. LC is reported in patients with celiac disease and in association with various drugs (NSAIDs, flutamide, cyclo 3 fort, and carbamazepine). The same features have also been observed in patients initially given a diagnosis of irritable bowel syndrome. These observations suggest that the histological picture of LC is the response to many disorders rather than a unique entity. A rare variant, “microscopic colitis with giant cells,” has been recognized, characterized by the presence of multinucleated giant cells in association with either LC or collagenous colitis. A paucicellular variant of LC characterized by the same clinical presentation has also been reported. Up to 80% (over a 38-month span according to one series) may experience a complete clinical and histological resolution. Collagenous Colitis