Incidental Chronic Colitis
Definition
- Isolated, asymptomatic changes of chronic colitis
Diagnostic Criteria
- Incidental finding on endoscopic biopsy
- Most commonly found during endoscopy for routine cancer screening
- Also seen during endoscopy to rule out/identify gi bleeding sites
- Endoscopic appearance may be normal, erythematous, congested or edematous
- No associated gi disorders
- Nearly always restricted to cecum/right colon
- Changes of chronic active colitis are present
- Crypt distortion and/or dropout
- Basal plasmacytosis
- Separates bases of crypts from muscularis mucosae (crypt shortening)
- Inflammation may extend into muscularis mucosae
- Acute inflammation present in most cases
- No granulomas
- May be histologically indistinguishable from Crohn disease or ulcerative colitis
- May be caused by non-steroidal anti-inflammatory drugs (NSAIDs)
- Frequently associated
- Cases reported of resolution following NSAID withdrawal
- NSAIDs are associatd with a variety of gi findings
- Frequently symptomatic and may include extensive ulceration
- This finding of isolated incidental chronic colitis is described by Deshpande
- Reported in adults
- Age range 46-80
Robert V Rouse MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342
Original posting / updates: 5/30/10
