Quantitative assessment of the subepithelial collagen band does not increase the accuracy of diagnosis of collagenous colitis.
The thickness of eosinophilic band in collagenous colitis (CC) was assessed by 3 methods: histologic estimates (22 observers), conventional measurements using a calibrated micrometric scale (1 observer), and semiautomatic micrometric measurements (1 observer). By the histologic estimate technique, 7.4% of the results failed to diagnose CC; by calibrated micrometry, the failure was 6% and by semiautomatic micrometry, 6%. The main difficulty in measuring the thickness of the CC band is that the deeper border of the band appears fuzzy and hairy-irregular. CC should be defined not exclusively on the basis of the thickness of the collagen table, but as a microscopic constellation characterized by a distorted superficial cell arrangement, with areas of epithelial denudation and inflammatory cells in the superficial epithelium and the lamina propria. In agreement with Lazenby's statement: "Focusing solely on the collagen band can result in both over- and underdiagnosis"
Rubio
Carlos A
CA
Department of Pathology, Karolinska Institute and University Hospital, Stockholm, Sweden.
Orrego
Abiel
A
Höög
Anders
A
Porwitz
Anja
A
Petersson
Fredrik
F
Elmberger
Göran
G
Glaessgen
Axel
A
Eriksson
Elina
E
Kanter
Lena
L
Jaremko
Georg
G
Egevad
Lars
L
Laforga
Juan
J
Liljefors
M
M
Löfdahl
Britta
B
Norman
Peter
P
Larsson
Olle
O
Wanat
Robert
R
Wejde
Johan
J
Zickert
Peter
P
Björk
Jan
J
Caini
Saverio
S
Palli
Domenico
D
Nesi
Gabriella
G
D003092:Colitis / Q000175:diagnosis* / Q000473:pathology; D003094:Collagen / Q000378:metabolism* / Q000648:ultrastructure; D003106:Colon / Q000473:pathology* / Q000648:ultrastructure; D003951:Diagnostic Errors; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology / Q000648:ultrastructure; D012189:Retrospective Studies
D003094:Collagen