OVERLAP IN SPECTRUM OF NONSPECIFIC INFLAMMATORY BOWEL-DISEASE - COLITIS INDETERMINATE
OVERLAP IN SPECTRUM OF NONSPECIFIC INFLAMMATORY BOWEL-DISEASE - COLITIS INDETERMINATE
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DOI：
10.1136/jcp.31.6.567
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发表时间：
1978-01-01
影响因子：
3.4
通讯作者：
PRICE, AB
中科院分区：
文献类型：
--
作者：
PRICE, AB
据称，10-20%的非特异性炎症性肠病[IBD]病例无法分类。确定了30例此类病例，在结肠切除术时指定为不确定性结肠炎。研究手术标本和任何可用的活检标本的组织病理学特征。几乎所有的病例都需要紧急手术，并且存在初期或已确立的暴发性疾病的特征。这些克罗恩病和溃疡性结肠炎的病理学重叠，鉴别特征很少或不可靠。克罗恩病的公认标准，即裂开性溃疡，透壁炎症和维持杯状细胞群，发现在随后被证明是溃疡性结肠炎的情况下。病害活动对形态特征的评价影响很大。当对静止期获得的活检材料进行检查时，许多困难都得到了解决。这些标本提供了疾病过程的动态视角，通常比在手术标本中看到的静态、非特异性急性疾病更有价值。不确定性结肠炎病例在IBD谱中形成一个小但独特的组，其特征在于呈现诊断困境的共同病理模式。
It is stated that 10-20% of cases of non-specific inflammatory bowel disease [IBD] cannot be classified. Thirty such cases, designated colitis indeterminate at the time of colectomy were identified. The histopathological features of the surgical specimens and any available biopsy specimens were studied. In nearly all the cases urgent surgery was required and the features of incipient or established fulminating disease were present. The pathology of these cases of Crohn''s disease and ulcerative colitis overlapped, and differentiating features were scant or unreliable. Accepted criteria of Crohn''s disease-namely, fissuring ulceration, transmural inflammation and a maintained goblet-cell population-were found in cases subsequently proved to be ulcerative colitis. Disease activity greatly affected the evaluation of morphological features. Many of the difficulties were resolved when biopsy material obtained during a quiescent phase was examined. These specimens gave a dynamic perspective of the disease process, often more valuable than the static, non-specific of acute disease seen in the surgical specimens. Cases of colitis indeterminate form a small but distinctive group in the spectrum of IBD which is characterized by a common pattern of pathology that presents a diagnostic dilemma.