Section of Colonic mucosa biopsy. The black arrow points to the - - PowerPoint PPT Presentation

Section of Colonic mucosa biopsy. The black arrow points to the shallow broad based ulcers. The blue arrow is on the intact muscularis Mucosa. The yellow arrow points to the Lymphoid hyperplasia. The red points to the crypt abscess.

R & D Histopath Lab, Chennai

• Dr. Meera Govindarajan, MD, DNB

Features of the biopsy which may be common to idiopathic colitis, Crohn;s disease and Tuberculosis in Colonic mucosa

• Severe colitis
• Crypt abscess

as pointed by the red arrow

• Regenerating

R & D Histopath Lab, Chennai

• Dr. Meera Govindarajan, MD, DNB
• Regenerating

base of crypts- black arrow

• Dense

inflammatory cell infiltrate - yellow

Complete block sectioning with 98 serial sections were cut . Another histopathological change was

• bserved in about 7 sections

R & D Histopath Lab, Chennai

• Dr. Meera Govindarajan, MD, DNB

Microscopic features which are in favour of the final diagnosis

• Broad based

shallow ulcers

• Absence of slit

like ulcer- a common feature

• f Crohn’s

R & D Histopath Lab, Chennai

• Dr. Meera Govindarajan, MD, DNB
• f Crohn’s
• Intact musclaris

mucosa- not seen in Crohn’s

• Multiple non

caseating granulomas – Black arrows

Higher power view of the same granulomas

Inview of the absence of slit like or fissure ulcers, absence of transmural involvement and lack of Sarcoid like granuloma with presence of early Langhan’s type of Giant cell , a diagnosis of Tuberculous colitis was suggested.

• Cluster of

pale spindle epitheliod cells cells

• An early

Langhan’s like giant cell

• Absence of

caseation and necrosis.