Surgical Pathology Criteria

Acute Self-limited Colitis

Differential Diagnosis

Ulcerative Colitis Acute Self-limited Colitis
Basal lymphoid aggregates frequent Basal lymphoid aggregates absent
Neutrophil infiltrate in crypts with frequent crypt abscesses Neutrophil infiltrate predominantly in lamina propria
Inflammation involves all levels of mucosa Inflammation largely restricted to upper and mid zones of mucosa
Architectural changes of chronic colitis are present Architecture is preserved
Duration at least 6 months Short duration
Common organisms include Salmonella, Shigella, Campylobacter, Yersinia and viruses  

 

Chemical / Iatrogenic Colitis Acute Self-limited Colitis
Predominantly intramucosal hemorrhage with sloughing Predominantly acute inflammation in upper lamina propria and crypts

 

Acute Self-limited Colitis Enterohemorrhagic E coli Colitis
Necrosis not typically seen Superficial mucosal necrosis
Hemorrhage and thrombosis not typically seen Frequent hemorrhage and capillary thrombosis

 

Incidental Chronic Colitis Acute Self-limited Colitis
Isolated disease, virtually restricted to cecum/right colon Usually multifocal or extensive
Histologic changes of chronic colitis present Changes of chronic colitis rare
Incidental, asymptomatic Nearly always symptomatic

 

  • Separation of severe cases from ischemic colitis and pseudomembranous colitis requires identification of the organism
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