Acute Self-limited Colitis
Inflammation of the colon due to infectious organisms, generally short term
- Predominantly acute inflammation largely restricted to lamina propria
- Neutrophilic involvement of crypt epithelium may be seen
- Crypt abscesses may be seen
- May be patchy or diffuse
- Lacks chronic changes of inflammatory bowel disease
- Minimal to no crypt distortion or drop out
- Mild to no chronic inflammatory infiltrate in lamina propria
- Persistent and severe infections may lead to mild crypt distortion
- Severe cases may lead to ulceration, hemorrhage and microthrombi
- Common causes include:
- Campylobacter jejunalis
- May have prominent macrophage infiltrate
- Lacks mucus depletion except in severe cases
- May have prominent macrophage infiltrate with erythrophagocytosis
- Mucus depletion
- Aphthous ulcers over lymphoid follicles
- Severe cases may ulcerate with a pseudomembrane
- May have aphthous ulcers
- May have necrotic granulomas
- May have prominent follicular hyperplasia
- About half of cases have no identifiable bacterial cause
- Many such cases are viral
- Stool ova and parasite examination is necessary to rule out parasitic cause
Robert V Rouse MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342
Original posting : November 11, 2009
Common organisms include Salmonella, Shigella, Campylobacter, Yersinia and viruses
||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
|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
||Nearly always symptomatic
Separation of severe cases from ischemic colitis and pseudomembranous colitis requires identification of the organism
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