Colonoscopy pathology report

In general nothing surprising.

Upper GI, no abnormalities

Lower small bowel, several biopsies showing inflammation consistent with returning Crohn's Disease

Large bowel, a couple of random biopsies show inflammation - this is new and not welcome news.  The technical term used was "focal active colitis"

I have an appt at the end of April with my doctor at which I will explore this new issue.  In the meantime, I'm hoping Remicade will take care of this issue.

FINAL PATHOLOGIC DIAGNOSIS:

A. Duodenum, biopsy:

Duodenal mucosa with intact villous architecture.
Negative for intraepithelial lymphocytosis or sprue-like injury.
Negative for foveolar metaplasia or Whipple's disease (Alcian blue/PAS stain).
Negative for luminal parasites, dysplasia or malignancy.

B. Ileocolonic anastomosis, biopsy:

Focal active ileitis with erosions.
Negative for pyloric metaplasia.
Negative for granulomas, dysplasia or malignancy.

C. Ileum, biopsy:

Chronic active ileitis with pyloric metaplasia (Alcian blue/PAS stain).
Negative for granulomas, dysplasia or malignancy.

D. Colon, random biopsy:

Focal active colitis.
Negative for granulomas, dysplasia or malignancy.
 

Comment:

The biopsies from the ileocolonic anastomosis show small bowel mucosa with focal neutrophilic inflammation. The biopsies from the ileum show small bowel mucosa with neutrophilic inflammation involving the surface epithelium, lamina propria and crypts along with extensive pyloric metaplasia; consistent with chronic active ileitis. The biopsies from the random colon show colonic mucosa with focal cryptitis and focal increased plasma cells. The clinical history of Crohn's disease is noted. No granulomas, viral inclusions, dysplasia or malignancy is identified.

COMMENTS:

CLINICAL HISTORY:

Signs, symptoms, medications and previous diagnoses:

Crohn's disease, large and small bowel, followup

Endoscopic findings:

Anal fissure and anal canal stenosis, patent end-to-side ileocolonic anastomosis, multiple erosions in neoterminal ileum, normal colon