The most common small objects missed were foci of inflammation, more specifically cryptitis
in colon biopsies.
There was no cryptitis
or crypt abscess, and no granuloma or parasites were seen.
The mucosal biopsy specimens revealed glandular distortion and cryptitis
with crypt abscess (Figure 2), which were compatible with UC.
Biopsies of the affected colon showed mucosal inflammation, characterized by focal infiltration of neutrophils, cryptitis
and crypt abscess, and non-necrotizing granulomas composed of epithelioid histiocytes.
Diagnostic considerations for structural pathology that are commonly associated with chronic anorectal pain includes cryptitis
, fissure, abscess, hemorrhoids, solitary rectal ulcer, inflammatory bowel disease, and rectal ischemia.
Flexible sigmoidoscopy performed by the GI specialists on hospital day 30 showed transmural inflammation (Figure 2), and biopsy returned cryptitis
and crypt abscess consistent with inflammatory bowel disease (IBD) (Figure 3).
Microscopically, the ileum and colon mucosa presented preserved architecture without cryptitis
or basal plasmacytosis (Figure l).
Colonoscopic biopsies revealed severe inflammation localized in the submucosa and mucosa histopathologically, cryptitis
and diffuse active colitis with local ulcerations.
The pathologist's review of the specimens revealed that in only 1 patient did the presence of actinomycosis evoke a minor cryptitis
, and in 3 patients there was an associated acute tonsillitis.
Rectal biopsy showed crypt distortion and cryptitis
, with heavy mixed inflammatory cell infiltration (mostly plasma cells and eosinophils) within lamina propria.
Characteristic histologic features include submucosal fibrosis, disruption of the muscularis mucosa, mild inflammation with or without eosinophils, and cryptitis
28) Acute inflammation (acute cryptitis
or crypt abscesses) can be present in the colon, ileum, and stomach, whereas villous blunting, mimicking celiac disease, can be present in the ileum and duodenum; features of chronic mucosal injury are usually lacking.