title: Quantitative assessment of the subepithelial collagen band does not increase the accuracy of diagnosis of collagenous colitis.
abstract: 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"
authors.affiliation: Department of Pathology, Karolinska Institute and University Hospital, Stockholm, Sweden.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Rubio
authors.forename: Abiel
authors.initials: A
authors.lastname: Orrego
authors.forename: Anders
authors.initials: A
authors.lastname: Höög
authors.forename: Anja
authors.initials: A
authors.lastname: Porwitz
authors.forename: Fredrik
authors.initials: F
authors.lastname: Petersson
authors.forename: Göran
authors.initials: G
authors.lastname: Elmberger
authors.forename: Axel
authors.initials: A
authors.lastname: Glaessgen
authors.forename: Elina
authors.initials: E
authors.lastname: Eriksson
authors.forename: Lena
authors.initials: L
authors.lastname: Kanter
authors.forename: Georg
authors.initials: G
authors.lastname: Jaremko
authors.forename: Lars
authors.initials: L
authors.lastname: Egevad
authors.forename: Juan
authors.initials: J
authors.lastname: Laforga
authors.forename: M
authors.initials: M
authors.lastname: Liljefors
authors.forename: Britta
authors.initials: B
authors.lastname: Löfdahl
authors.forename: Peter
authors.initials: P
authors.lastname: Norman
authors.forename: Olle
authors.initials: O
authors.lastname: Larsson
authors.forename: Robert
authors.initials: R
authors.lastname: Wanat
authors.forename: Johan
authors.initials: J
authors.lastname: Wejde
authors.forename: Peter
authors.initials: P
authors.lastname: Zickert
authors.forename: Jan
authors.initials: J
authors.lastname: Björk
authors.forename: Saverio
authors.initials: S
authors.lastname: Caini
authors.forename: Domenico
authors.initials: D
authors.lastname: Palli
authors.forename: Gabriella
authors.initials: G
authors.lastname: Nesi
mesh_terms: 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
chemical_list: D003094:Collagen