Histological evaluation in ulcerative colitis

作     者：Tom C.DeRoche Shu-Yuan Xiao Xiuli Liu 

作者机构：Department of PathologyWake Forest Baptist Medical CenterWinston-SalemNorth CarolinaUSA Department of PathologyUniversity of ChicagoChicagoIllinoisUSA Department of Anatomic PathologyCleveland ClinicClevelandOhioUSA 

出 版 物：《Gastroenterology Report》 (胃肠病学报道（英文）)

年 卷 期：2014年第2卷第3期

页      面：178-192页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：ulcerative colitis histological evaluation dysplasia differential diagnosis 

摘      要：This review summarizes diagnostic problems,challenges and advances in ulcerative colitis(UC).It emphasizes that,although histopathological examination plays a major role in the diagnosis and management of UC,it should always be interpreted in the context of clinical,endoscopic,and radiological *** diagnosis requires knowledge of the classic morphological features of UC,as well as a number of atypical pathological presentations that may cause mis-classification of the disease process,either in resection or biopsy *** atypical pathological presentations include rectal sparing and patchiness of disease at initial presentation of UC in pediatric patients or in the setting of medically treated UC,cecal or ascending colon inflammation in left-sided UC,and backwash ileitis in patients with severe ulcerative *** formed microgranulomas,with pale foamy histiocytes adjacent to a damaged crypt or eroded surface,should not be interpreted as evidence of Crohn’s *** colitis should only be used in colectomy specimens as a provisional pathological *** with UC are at risk for the development of dysplasia and carcinoma;optimal outcomes in UC surveillance programs require familiarity with the diagnostic criteria and challenges relating to UC-associated dysplasia and *** biopsy from UC patients should always be evaluated for dysplasia based on cytological and architectural *** interpretation and classification of dysplasia in colon biopsy from UC patients as sporadic adenoma or UC-related dysplasia[flat,adenoma-like,or dysplasia-associated lesion or mass(DALM)]requires clinical and endoscopic *** polypoid dysplastic lesions are considered to be sporadic adenoma if occurring outside areas of histologically proven colitis,or adenoma-like dysplasia if occurring in the diseased *** data suggest that such lesions may be treated adequately by polypectomy in the