Ulcerative colitis


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  • Clinical

    • male > female
    • age: peaks in 15-25 and 70s
    • chronic, recurrent bloody diarrhea
    • associations: familial
    • labs: pANCA+, ASCA-

  • Gross

    • continuous, rectum to proximally, confined to colon
    • erythema, ulceration
    • inflammatory polyps

  • Histology

    • IBD features
      • erosions, ulcerations
      • crypts: crypt dropout, cryptitis, crypt abscess
      • fibrosis
    • UC features: mucosa confined, PMN predominance
    • treated UC can have skip lesion

  • Ddx

  • Signout

    • biopsy
      • moderate/severe chronic active colitis
      • no dysplasia, granulomas, or viral cytopathic effect identified
      • Comment: these findings could be consistent with ulcerative colitis in the appropriate clinical setting
    • resection
      • moderate/severe chronic active colitis
      • ___ other IBD and UC features
      • consistent with history of ulcerative colitis
      • surgical margins viable and uninvolved
      • no dysplasia, granulomas or viral cytopathic effect identified
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