Carcinogenesis ; pathology ; Colitis ; pathology ; Humans

No abstract available.
Colitis, Collagenous/*pathology ; Colitis, Lymphocytic/*pathology ; *Colonoscopy ; Female ; Humans ; Intestinal Mucosa/*pathology ; Male

No abstract available.
Colitis, Collagenous/*pathology ; Colitis, Lymphocytic/*pathology ; *Colonoscopy ; Female ; Humans ; Intestinal Mucosa/*pathology ; Male

Colitis, Ulcerative ; classification ; diagnosis ; pathology ; Humans ; Inflammation ; Medicine, Chinese Traditional

Ulcerative colitis (UC), a kind of chronic nonspecific intestinal inflammation with unknown etiology, is very difficult to cure. It recurs often and even is accompanied with parenteral lesion. It has been rated as one of contemporary refractory diseases by World Health Organization. The author combines the pathological mechanisms of UC with the poison-evil theory and the collateral disease theory, and puts forward that "toxin impairing intestine collateral" pathogenesis theory. We believe that longer accumulation of damp-heat stasis toxin that damages the intestine collateral is the key cause for recurrence and relapses of UC. We explained its theory foundation in terms of pathogenesis of UC from Chinese medicine and modern medicine. The "toxin impairing intestine collateral" theory might perfect the syndrome typing system for UC, and provide a new way of thinking for treating UC.
Colitis, Ulcerative ; diagnosis ; etiology ; pathology ; Humans ; Medicine, Chinese Traditional ; methods

BACKGROUND/AIMS: Although normal endoscopic findings are, as a rule, part of the diagnosis of microscopic colitis, several cases of macroscopic lesions (MLs) have been reported in collagenous colitis, but hardly in lymphocytic colitis (LC). The aim of this study was to investigate the endoscopic, clinical, and histopathologic features of LC with MLs. METHODS: A total of 14 patients with LC who were diagnosed between 2005 and 2010 were enrolled in the study. Endoscopic, clinical, and histopathologic findings were compared retrospectively according to the presence or absence of MLs. RESULTS: MLs were observed in seven of the 14 LC cases. Six of the MLs exhibited hypervascularity, three exhibited exudative bleeding and one exhibited edema. The patients with MLs had more severe diarrhea and were taking aspirin or proton pump inhibitors. More intraepithelial lymphocytes were observed during histologic examination in the patients with MLs compared to the patients without MLs, although this difference was not significant. The numbers of mononuclear cells and neutrophils in the lamina propria were independent of the presence or absence of MLs. CONCLUSIONS: LC does not always present with normal endoscopic findings. Hypervascularity and exudative bleeding are frequent endoscopic findings in patients with MLs.
Adult ; Aged ; Colitis, Collagenous/*pathology ; Colitis, Lymphocytic/complications/*pathology ; Colon/pathology ; *Colonoscopy ; Diagnosis, Differential ; Diarrhea/etiology ; Female ; Humans ; Intestinal Mucosa/*pathology ; Male ; Middle Aged ; Retrospective Studies

BACKGROUND/AIMS: Although normal endoscopic findings are, as a rule, part of the diagnosis of microscopic colitis, several cases of macroscopic lesions (MLs) have been reported in collagenous colitis, but hardly in lymphocytic colitis (LC). The aim of this study was to investigate the endoscopic, clinical, and histopathologic features of LC with MLs. METHODS: A total of 14 patients with LC who were diagnosed between 2005 and 2010 were enrolled in the study. Endoscopic, clinical, and histopathologic findings were compared retrospectively according to the presence or absence of MLs. RESULTS: MLs were observed in seven of the 14 LC cases. Six of the MLs exhibited hypervascularity, three exhibited exudative bleeding and one exhibited edema. The patients with MLs had more severe diarrhea and were taking aspirin or proton pump inhibitors. More intraepithelial lymphocytes were observed during histologic examination in the patients with MLs compared to the patients without MLs, although this difference was not significant. The numbers of mononuclear cells and neutrophils in the lamina propria were independent of the presence or absence of MLs. CONCLUSIONS: LC does not always present with normal endoscopic findings. Hypervascularity and exudative bleeding are frequent endoscopic findings in patients with MLs.
Adult ; Aged ; Colitis, Collagenous/*pathology ; Colitis, Lymphocytic/complications/*pathology ; Colon/pathology ; *Colonoscopy ; Diagnosis, Differential ; Diarrhea/etiology ; Female ; Humans ; Intestinal Mucosa/*pathology ; Male ; Middle Aged ; Retrospective Studies

BACKGROUND/AIMS: Ulcerative colitis is an inflammatory bowel disease with unknown etiology, which has waxed and waned course. It is diagnosed by colon study, pathology, and especially colonoscopy. It is difficult to differentiate between ulcerative colitis and other infectious colitis, especially amebic colitis, and to confirm of remnant lesion by endoscopic findings. METHODS: Magnifying colonoscopy has 100 time magnifying power compared to 30 time of conventional colonoscopy. By spraying 0.2% indigo carmine dye, we evaluated the magnifying and microscopic findings of 31 colonic mucosa of 23 patients with ulcerative colitis. RESULTS: Initial and magnifying chromoscopic findings in ulcerative colitis were loss of cryptal opening 72% (13/18), loss of submucosal vessel 89% (16/18), mucosal denudation (or microscopic erosion) 83% (15/18), and mucosal unevenness 94% (17/18). Recovery rate of magnifying chromoscopic findings after treatment in ulcerative colitis were in crytal opening 80% (8/10), submucosal vascularity 60% (6/10), mucosal denudation (microscopic erosion) 30% (3/10), and in mucosal unevenness 40% (4/10). CONCLUSIONS: It is suggested that magnifying chromoscopic findings in ulcerative colitis may be useful in initial diagnosis and confirmation of remnant lesion, but, not in prediction of clinical severity.
Colitis ; Colitis, Ulcerative* ; Colon ; Colonoscopy ; Diagnosis ; Dysentery, Amebic ; Humans ; Indigo Carmine ; Inflammatory Bowel Diseases ; Mucous Membrane ; Pathology ; Ulcer*

PURPOSE: To determine the value of the CT scan in distinguishing an ischemic and a tumoral segment in coloniccarcinoma complicated by proximal bowel ischemia. MATERIALS AND METHODS: CT scans of twenty patients with ischemic colitis proximal to obstructing colonic carcinoma were reviewed retrospectively. The presence of anischemic segment proximal to colonic carcinoma were patho-logically confirmed in 12 patients, and the remaining eight patients showed typical radiologic findings of bowel ischemia on barium enema but on pathologic review showed only colonic carcinoma. CT scans were analyzed for the location, wall thickness, length, and enhancing pattern of both tumoral and ischemic segments in correlation with barium enema or surgico-pathologic results. Theresults of tumor staging shown on CT scan were compared with those of pathologic findings. RESULTS: On CT scan adistinction between ischemic and tumoral segments could be made in 15 patients (75%). The ischemic segments were contiguously proximal to the tumoral segment in 18 patients. In two patients, however, there was an intervening segment of normal bowel between the two segments and this was confirmed by pathology. Maximvm bowel wall thickness ranged from 0.8 to 4.5cm (mean, 2.0cm) in tumoral segments and from 0.6 to 1.5 cm (mean, 1.0cm) in ischemic segments (p<0.05). Tumoral segments were enhanced heterogeneously in 12 patients (60%) and homogeneously in the remaining eight, while ischemic segments were enhanced homogeneously in 14 patients (70%) and heterogeneously insix. Peripheral rim enhancement was seen only in the ischemic segments of four patients (20%). Comparing TNM tumorstaging of the CT scan with that of pathology, CT scan overstaged in two patients (10%) and understaged in one(5%). CONCLUSION: CT is a valuable tool for distinguishing an ischemic from a tumoral segment in patients with ischemic colitis proximal to colonic carcinoma. An understanding of this pathologic entity could reduce the possibility of over or understaging in cases of colonic carcinoma.
Barium ; Colitis ; Colitis, Ischemic* ; Colon* ; Enema ; Humans ; Ischemia ; Logic ; Neoplasm Staging ; Pathology ; Retrospective Studies ; Tomography, X-Ray Computed

Nowadays, inflammatory bowel disease, such as ulcerative colitis and Crohn's disease, is increasing; however, infectious colitis, such as amebic colitis, is decreasing, so many doctors are not apt to be interested in infectious colitis. In addition, recently amebic colitis has been relatively rare in Korea, and the colonoscopic and the pathologic findings of amebic colitis are very similar to those of other inflammatory bowel diseases. As a consequence, the diagnosis is very difficult if the cyst or the trophozoite of the ameba is not found in the stool examination or in the tissue pathology. The authors experienced three cases in which initial diagnoses of tuberculous colitis, ulcerative colitis, and a simple ulcer were made based on colonoscopic and X-ray findings. However a colonoscopic biopsy revealed a trophozoite form of ameba in the tissue. Hence, a diagnosis of amebic colitis could be made with confidence. Based on these results, we insist that infectious colitis should be included in the differential diagnosis when making a diagnosis of inflammatory bowel disease. In addition, it is extremely important to consider all kinds of infectious colitis, such as amebic colitis.
Amoeba ; Biopsy ; Colitis* ; Colitis, Ulcerative ; Crohn Disease ; Diagnosis ; Diagnosis, Differential ; Dysentery, Amebic* ; Inflammatory Bowel Diseases ; Korea ; Pathology ; Trophozoites ; Ulcer