COLON: INFECTIOUS COLITIS (SELF LIMITED COLITIS)

Clasiccallly, no crypt disarray 

the circles indicate neutrophils inside crypts (cryptitis). In the right picture surface neutrophils with damage of epithelium 

No crypt distortion, the right picture indicates neutrophilic infiltration of crypts

The red square and circle  show microabscesses

Left. the red circle shows neutrophil, Right the red arrows indicates severe cryptitis

HISTOLOGICAL FINDINGS OF INFECTIOUS COLITIS:
1.-No crypt disarray or distortion.
2.- Neutrophilic infiltration in crypts (cryptitis) and surface epithelium, sometimes microabscess
3.-Damage of epithelium.

biblio:Odze RD, Goldblum JR: Surgical Pathology of the GI Tract, Liver, Biliary Tract, and Pancreas, 2nd ed. Elsevier: Philadelfia 2009 and Greenson  Diagnostic Gastrointestinal and Liver Pathology ,Lippincott Williams &Wilkins, 2009.

COLON LIPOMA

The diagnosis is easy when you have the surgical specimen.

This was more difficult, but the endoscopy was more clear. The red square indicates submucosal fatty tissue

This is pseudolipomatosis (it is air  trapped in mucosa)  but  it can confuse  with lipoma

HISTOLOGICAL FINDINGS OF LIPOMA
1.- Rounded submucosal mass of mature adipose tissue

Odze RD, Goldblum JR: Surgical Pathology of the GI Tract, Liver, Biliary Tract, and Pancreas, 2nd ed. Elsevier: Philadelfia 2009
Greenson  Diagnostic Gastrointestinal and Liver Pathology ,Lippincott Williams &Wilkins, 2009.

COLON: ULCERATIVE COLITIS

HISTOLOGICAL FINDINGS IN  ULCERATIVE COLITIS
1.- Crypt distortion: shortening and branching crypts., pseudovellous surface.
2.-Lymphoplasmocitosis basal.
3.- microabscess and cryptitis.

biblio:Odze RD, Goldblum JR: Surgical Pathology of the GI Tract, Liver, Biliary Tract, and Pancreas, 2nd ed. Elsevier: Philadelfia 2009 and Greenson  Diagnostic Gastrointestinal and Liver Pathology ,Lippincott Williams &Wilkins, 2009.

COLON: EOSINOPHILIC COLITIS

the blue circles indicate eosinophils, in this picture , the number is approximately 15.

HISTOLOGICAL FINDINGS IN EOSINOPHILIC COLITIS
1.-No crypt disarray or distortion (except in case secondary to ulcerative colitis or Crohn s disease).
2.-Increase in number or eosinophils, greater than 20 eosinophils/hpf, another authors use greater than 60/10hpf.
3.-Abnormal location of eosinophils: within epithelium  or basal (close to muscularis mucosae), and some degranulated.
4.- Clusters and degranulated eosinophils.

biblio:Odze RD, Goldblum JR: Surgical Pathology of the GI Tract, Liver, Biliary Tract, and Pancreas, 2nd ed. Elsevier: Philadelfia 2009 and Greenson  Diagnostic Gastrointestinal and Liver Pathology ,Lippincott Williams &Wilkins, 2009.

COLON ADENOCARCINOMA USUAL OR NOS TYPE

Moderately differentiated Adenocarcinoma, this case shows villous pattern, in the left, it is evident the infiltration to lamina propia, with desmoplasia

This case shows marked papllary pattern

This case was easy, classic picture of Adenocarcinoma usual type, moderately differentiated. Atypical fused gland surrounded by desmoplastic stromal response

DUODENUM NORMAL

Brunner glands.only  in the first part of duodenum

COLON: HYPERPLASTIC POLYP

Hyperplastic polyp: globet cell type

Hyperplastic polyp: globet cell type

Hyperplastic polyp: microvesicular type

Hyperplastic polyp : inverted type

Hyperplastic polyp: globet cell type

Hyperplastic polyp : poor mucin type

Hyperplastic polyp: microvesicular type

COLON: NEUROENDOCRINE NEOPLASIA WELL DIFFERENTIATED

CHROMOGRANIN  POSITIVE.: This picture belongs to the above case. , I want remark that  synaptophisin was negative in this case.

This case was easier, but very nice because , as you can see, there is an adenoma over the monotonous cells.

 Beautiful nests of monotonous cells with pink granular cytoplasm and round-oval nuclei, small nucleoli, minimal pleomorphism, 

COLON: LYMPHOCYTIC COLITIS

Red circles indicate intraepithelial lymphocytes; They are different to nucleus of epithelial cells, more rounded and darker. In this case , the count was 40 iel /100 epithelial cells.

Red circles indicate intraepithelial lymphocytes; They are different to nucleus of epithelial cells, more rounded and darker, besides the epithelial damage can be observed

Another case,a patient with chronic diarrhea,. Intraepithelial lymphocytosis  with  epithelial damage more evident

Sometimes, with immersion oil  100x, the difference between  epithelial nuclei and lymphocytes is more clear

HISTOLOGICAL FINDINGS IN LYMPHOCYTIC COLITIS
1.-Intraepithelial lymphocytosis , more than 20 iel/ 100 epithelial cells.
2.- Surface epithelial damage
3.- No crypt distortion.

biblio:Odze RD, Goldblum JR: Surgical Pathology of the GI Tract, Liver, Biliary Tract, and Pancreas, 2nd ed. Elsevier: Philadelfia 2009 and Greenson  Diagnostic Gastrointestinal and Liver Pathology ,Lippincott Williams &Wilkins, 2009.