Large numbers of crypt abscesses are probably indicative of either superimposed infection or a separate diagnosis such as UC.
Be aware that some histologic features normally associated with inflammatory bowel disease, including crypt irregularity and neutrophilic cryptitis and even crypt abscesses, may be encountered in a minority of those with LC, and that the presence of one or more of these features should not necessarily be interpreted as evidence incompatible with LC.
Crypt abscesses and Paneth metaplasia may be present as well, which may cause confusion with inflammatory bowel disease.
Although cryptitis and crypt abscesses may be encountered, these are usually not prominent.
Histologically, the mucosa undergoes changes that mimic full-blown inflammatory bowel disease, with increased lymphoplasmacytic lamina propria cellularity, basal lymphoid aggregates, acute cryptitis, and even crypt abscesses.
In 2 cases reviewed (cases 7 and 8), acute cryptitis and crypt abscesses were noted.
However, crypt abscesses may be absent in the quiescent phase of IBD and, as we and others[2, 3] describe, may be present in ischemia.
Atypical Reactive Changes True Dysplasia Secondary to Secondary to Ischemia Inflammatory Bowel Disease (Pseudodysplasia Acute cryptitis and Acute cryptitis and crypt crypt abscesses uncommon abscesses common Inflammatory changes, Inflammatory changes diffuse when present, are patchy (present in biopsy specimens from multiple areas of bowel) Histologic changes Histologic changes of of ischemia present ischemia absent Hemosiderin may be Hemosiderin never present present in the mucosa in the mucosa