title: Histological discrimination of idiopathic inflammatory bowel disease from other types of colitis.
abstract: OBJECTIVE
  To assess the value of histology in diagnosing inflammatory bowel disease (IBD) in colorectal biopsy specimens.
  
  
  METHODS
  Retrospective, double blind evaluation of colorectal biopsy specimens from 41 patients with colitis (28 with ischaemic colitis and 13 with acute self-limited colitis) and 84 patients with IBD (42 with Crohn's disease and 42 with ulcerative colitis).
  
  
  RESULTS
  The features distinguishing IBD from other forms of colitis included distorted architecture, lymphocyte and plasma cell infiltrate, excess of polymorphonuclear leucocytes, polymorphonuclear cryptitis, crypt abscesses, and basal lymphoid aggregates. The features discriminating between Crohn's disease and ulcerative colitis included an irregular or villous surface, distorted architecture, decrease in mucus content, and polymorphonuclear cryptitis. Using multivariate analysis, 90% of patients with Crohn's disease and 71% of those with ulcerative colitis were correctly classified, the former being strongly defined by epithelioid granulomas, microgranulomas and isolated giant cells, and the latter best defined by an irregular or villous surface, decrease in mucus content and crypt atrophy.
  
  
  CONCLUSIONS
  Examination of colorectal biopsy specimens is a reliable method for diagnosing IBD. In the absence of epithelioid granulomas, microgranulomas and isolated giant cells a diagnosis of Crohn's disease is based on the absence of histological criteria favouring ulcerative colitis. The histological spectrum of indeterminate colitis remains to be clarified.
authors.affiliation: Department of Pathology B, CHRU Pontchaillou, Rennes, France.
authors.forename: N
authors.initials: N
authors.lastname: Le Berre
authors.forename: D
authors.initials: D
authors.lastname: Heresbach
authors.forename: M
authors.initials: M
authors.lastname: Kerbaol
authors.forename: S
authors.initials: S
authors.lastname: Caulet
authors.forename: J F
authors.initials: JF
authors.lastname: Bretagne
authors.forename: J
authors.initials: J
authors.lastname: Chaperon
authors.forename: M
authors.initials: M
authors.lastname: Gosselin
authors.forename: M P
authors.initials: MP
authors.lastname: Ramée
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003092:Colitis / Q000473:pathology*; D003093:Colitis, Ulcerative / Q000473:pathology*; D003106:Colon / Q000473:pathology; D003424:Crohn Disease / Q000473:pathology*; D003937:Diagnosis, Differential; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012007:Rectum / Q000473:pathology; D015203:Reproducibility of Results; D012189:Retrospective Studies