Histology Course S I 13 Department of Pathology, University of Zurich Histokurs

S I 13 ulcerative colitis HE further information (German) on HiPaKu
  ICD-10: K51.9

46-year-old female with lower abdominal, colicky pain and bloody diarrhoea. Endoscopy of the entire colon reveals ulcers and mucosal polyps.

- The mucosa and submucosa show ulceration and infiltration, predominantly with plasma cells (crypt abscess?). The disturbed architecture of the mucosa and the appearance of Paneth cells signify a chronic inflammation.
-The disturbance of architecture and the fact that the inflammation is limited to the inner wall layers fit the diagnosis of ulcerative colitis. Further typical features are the abscesses in the crypts as well as the varying degree of dysplasia of the cryptal epithelium.

The diagnosis of an ulcerative colitis cannot be made based on the morphology of a small section of the colon but requires an examination of at least a large section of colon or better still, of the entire colon with clinical, endoscopical and radiological evidence which support the diagnosis. The disease starts at the distal part of the rectum and extends proximally. The dysplasia of the epithelium is important as ulcerative colitis is associated with an increased risk of carcinoma of the colon.