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World J Gastroenterol. Sep 28, 2014; 20(36): 13139-13145
Published online Sep 28, 2014. doi: 10.3748/wjg.v20.i36.13139
Published online Sep 28, 2014. doi: 10.3748/wjg.v20.i36.13139
Identification of pathologic features associated with “ulcerative colitis-like” Crohn’s disease
Samuel D James, M Kay Washington, Chanjuan Shi, Departments of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN 37232, United States
Paul E Wise, Section of Colon and Rectal Surgery, Washington University in St. Louis, Gainesville, MO 63130, United States
Tania Zuluaga-Toro, Department of Pathology, University of Florida, Gainesville, FL 32611, United States
David A Schwartz, Departments of Gastroenterology, Hepatology and Nutrition, Vanderbilt University Medical Center, Nashville, TN 37232, United States
Author contributions: James SD and Shi C performed the majority of the microscopic evaluations and wrote the manuscript; Wise PE and Schwartz DA provided clinical and surgical management of patients involved in the study and were also involved in editing the manuscript; Shi C, Washington MK and Zuluaga-Toro T designed the study and were also involved in editing the manuscript.
Correspondence to: Chanjuan Shi, MD, PhD, Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, 1161 21st Avenue South, C-3321 MCN, Nashville, TN 37232, United States. chanjuan.shi@vanderbilt.edu
Telephone: +1-615-9368342 Fax: +1-615-3437023
Received: January 4, 2014
Revised: March 29, 2014
Accepted: April 30, 2014
Published online: September 28, 2014
Revised: March 29, 2014
Accepted: April 30, 2014
Published online: September 28, 2014
Core Tip
Core tip: Despite well-established clinical and pathological criteria, a fraction of Crohn’s disease (CD) cases are diagnosed as ulcerative colitis (UC). Given the significant difference in standard surgical management for UC and Crohn’s colitis, it is critical to identify as many factors as possible which may help distinguish the two entities. In this study we have identified several pathologic features which may assist in identifying a subgroup of inflammatory bowel disease cases known as “UC-like” CD. More severe disease in the proximal involved region, terminal ileum involvement, active appendicitis, and prominent lamina propria neutrophils may be morphological factors associated with “UC-like” CD.