Ulcerative Colitis - Contemporary Morphological Criteria

Overview

Regular bioptical examinations of patients with ulcerative colitis (UC) performed in recent yearsshow that the inflammatory changes of the mucosa of the large intestine are not necessarilydiffuse, and that their extent may vary in the course of the disease. To establish the diagnosis ofUC and to assess the treatment efficacy it is important to examine histologically multiple mucosalspecimens from different levels of the large intestine. In our series of 27 patients with ulcerativecolitis (18 men and 9 women at the age of 17 to 76 years), active or active and inactive pancolitiswas diagnosed in 25 cases (93 %). In 11 of these, the whole of the large intestine was affected. Twopatients showed diffuse pancolitis without caecal involvement, in 5 cases there was inactiveinflammation in the rectum or in the sigmoid colon. Seven patients had active colitis of therectum and sigmoid. In another 2 patients (7 %), the inflammation was limited to several segmentsof the large intestine only (the descending colon, and the descending and transverse colon). Onbioptical examination of 6 patients repeated after 2–29 months (mean 14 months), there werechanges in the distribution and appearance of the inflammation. Thus our findings correspondwith the results of previous studies: UC does not always affect the mucosa of the large intestinediffusely. Further, the extent and distribution of inflammatory changes vary in the course of thedisease.

Key words:
ulcerative colitis – morphological diagnosis – sets of biopsies of the mucosa of the largeintestine – diffuse and focal type of inflammation in UC – repeated bioptical examination of thelarge intestine.