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File:Colitis with granuloma high mag.jpg

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English: High magnification micrograph of a colitis with granulomatous inflammation. Colonic biopsy. HPS stain.

The colonic mucosa shows abundant plasma cells and many eosinophils. Neutrophils are seen between enterocytes indicative of cryptitis. There is some suggestion of intestinal crypt architectural distortion and crypt loss, findings that are consistent with a chronic colitis. There is a moderately well-formed collection of (epithelioid-type) histocytes in the mucosa, i.e. a granuloma. Necrosis is not seen in this granuloma. The granuloma is surrounded by acute inflammatory cells and adjacent to a inflammed crypts.

The findings are suggestive of inflammatory bowel disease, but cannot exclude other chronic colitides. As the granuloma is superficial, and adjacent to an actively inflammed crypt, it has a low specificity for Crohn's disease, i.e. the findings in this image could be consistent with ulcerative colitis.[1][2]

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  1. ↑ (Aug 2002). "Granulomas in the diagnosis of intestinal Crohn's disease: a myth exploded?". Histopathology 41 (2): 166-8.
  2. ↑ (Jul 2002). "Granulomatous ulcerative colitis: a re-appraisal of the mucosal granuloma in the distinction of Crohn's disease from ulcerative colitis.". Histopathology 41 (1): 50-5.
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