Interesting pathology in your report.
Generally, with ulcerative colitis pathology in a biopsy, you are looking for signs of inflammation/swelling, bleeding, frail/thin tissue, abnormalities within cell crypts (more on that in a moment), abnormal cell architecture, and infiltration of cells in places they do not normally belong.
Of those things I mentioned you have two.
1.) "The architecture is disturbed with crypt branching, crypt shortening and crypt dropout. There is a focal cryptitis but no crypt abscesses seen."
Remember before that I was talking about
abnormalities within cell crypts? Well you've got them and we're going to dive further into that in just a bit. First, the surface of a normal intestine is like waves on the ocean, with crests and valleys in a wave-like pattern. Crypts are the low points (like valleys) and they are of particular interest within an ulcerative colitis diagnosis. They tend to get inflamed (cryptitis), full of junk that doesn't belong there (crypt abscesses), and have other deformations as a result of chronic, ongoing inflammation. Your crypts are inflamed (cryptitis), have branching, shortening and dropout, all of which are deformations usually attributed with a chronic underlying cause.
2.)"The lamina propria contains dense collections of mononuclear inflammatory cells admixed with neutrophils."
Remember earlier I was talking about
infiltration of cells in places they do not normally belong? You got it and that's usually a differentiating factor between short term infections and long term, chronic conditions. A normal large intestine has a defensive mucosa layer, a barrier that's designed to keep pathogens from infiltrating deep into our body tissue. The lamina propria is one of the internal layers beyond that mucosa defense. Your report is saying that your mucosa layer has been penetrated and has a collection of immune cells beyond it, and where there are dense collections of immune cells present there are other invaders that they are trying to stop/fight.
Certainly, this is not a typical pathology for an ulcerative colitis patient but there are some signs of chronic involvement. I wouldn't call it a homerun or slam-dunk UC pathology. I'd expect to see crypt abscesses, redness, a disrupted blood vessel pattern, more signs of swelling or inflammation, more signs of cell deformations, and probably frailability as well. Maybe this combined with the visual colonoscopy report are enough to give a UC diagnosis. I'd probably question your doctor when you see him/her next on whether he/she is certain it's UC and not something else (Infectious-Proctitis versus Ulcerative Proctitis, etc..). I'm no doctor or pathologist though, so take it for what it's worth haha.
And to clarify, you're Ulcerative Colitis diagnosis would be Proctitis or UP (rectum only involvement).
Moderator Ulcerative Colitis
John, 38, in a minor flare, UC Proctosigmoiditis
Rx: Remicade @5mgs/kg/6wks; 50mgs 6MP, 4.8g Lialda, 15mgs pred (tapering)You might have UC if a "You Only Live Once" decision applies to a food or beverage that you know will be a big, big regret next morning. Mr colon is going to throw himself a fit when he sees this, oh well.
Post Edited (iPoop) : 10/28/2016 11:58:32 AM (GMT-6)