Pathology Report

I got my report in the mail. Can you interpret?

From the rectal biopsy:

Mixed acute and chronic inflammatory infiltrate within the lamina propria and crypts with small epithelial microabscesses. Evidence of crypt distortion and regeneration as well as granulomas. Scattered granualation tissue is present. No dysplasia. Although changes not specific they would be consistent with those that can be seen in IBD. Clinical correlation is suggested.

Report also indicates Chronic Active Colitis. Just wondering about the granulomas as well due to reading about that in Chron's?

Thanks

Hello,

Terminal Ileum and Random Right Colon are benign showing essentially no pathologic changes.

Sections of the ileum show benign appearing villi with a usual lymphoid infiltrate. The mucosa shows essentially no pathologic changes.

emedicine.medscape.com/article/183084-differential

This could be helpful, and while granulomas can happen in other instances of specific disease, they are not in diagnosis of UC.

When will you be seeing your GI?

q

Sure, i'll help translate.

"Mixed acute and chronic inflammatory infiltrate within the lamina propria"

Our large intestines are lined with a thin layer of protective mucus that's meant to keep bacteria, fungus, and other baddies from contacting our body tissue. Immune cells were found beyond that barrier meaning something got through your defenses and your immune system is responding by attacking it there. Your inflammation was mild, the lowest grade. Some of it was clearly chronic changes (meaning cell architecture changed, others could be short-term-infectuous/acute as the architecture hasn't yet been changed). The presence of chronic means it's all likely to be crohnic in nature.

"crypts with small epithelial microabscesses. Evidence of crypt distortion"

A normal large intestines surface is like waves on water with high points and low points. The low points are known in medical jargon as crypts. Crypts are of particular interest with ulcerative colitis patients and are a distinct feature suggestive of UC as ours are always weird in appearance within a biopsy. Your crypts meet this description: they're distorted and have irregularities known as absesses .

" as well as granulomas. Scattered granualation tissue is present."

Granulomas are suggestive of inflammation. The intestinal wall is usually smooth (like the walls of your mouth and throat that's visible within a mirror) . Your large intestine had a very grainy and rough texture, likely inflammatory in origin.

"No dysplasia."

All scopes look for signs of cancer and precancerous changes (known as dysplasia). The good news is you don't have it.

"Although changes not specific they would be consistent with those that can be seen in IBD. Clinical correlation is suggested."

No singular test diagnoses, rather a series of tests all pointing to the same illness do. If all tests agree then it's IBD.

"Report also indicates Chronic Active Colitis. Just wondering about the granulomas as well due to reading about that in Chron's?"

Chronic active colitis means IBD, a chronic illness. That's what my reports and everyone's say. All of your crypt findings and everything I've read are suggestive of UC. IBD is an umbrella including UC and Crohn's, as well as many other variants like Crohn's-colitis, indeterminate-colitis among others as well. I'd say probable UC but Crohn's-colitis isn't impossible. Granulomas are a more crohn's like feature.

Treatments overlap so there's a few minor differences but overall it's very simular. Let us know what your gasteroenterologist says upon your follow up appointment where he/she will go over your tests!