Pathology of Inflammatory Bowel Disease

Question 1

This inflammatory bowel disease has sharp borders with psuedopolyps.

Answer 1

Ulcerative colitis

Question 2

This form of IBD is characterized by skip lesions and strictures in any part of the GI tract.

Answer 2

Crohn’s Disease

Question 3

True/False. Granulomas are present on histologic analysis of ulcerative colitis.

Answer 3

False - granulomas are only present histologically in Crohn’s disease. Both may include crypt abscesses.

Question 4

What term describes ulcerative colitis that involves the entire colon?

Answer 4

Pancolitis

Question 5

This complication presents in severe cases of ulcerative colitis and poses a risk of colonic perforation.

Answer 5

Toxic megacolon - colonic dilation due to inflammation of the muscularis propria

Question 6

What is the strongest risk gene associated with Crohn’s Disease?

Answer 6

NOD2

Question 7

This form of IBD is characterized by continuous colonic involvement that begins in the rectum.

Answer 7

Ulveritive Collitis

Question 8

What cholestatic condition is most associated with ulcerative colitis vs. Crohn’s disease?

Answer 8

Primary sclerosing cholangitis

Question 9

True/False. Ulcerative colitis carries a higher risk of colonic adenocarcinoma than Crohn’s disease.

Answer 9

True

Question 10

How does ulcerative colitis differ from Crohn’s disease?

Answer 10

Ulcerative colitis inflammation is limited to the mucosa and does not involve deeper mucosal or muscular layers.

Pseudopolyps without cobblestone appearance

No thickening of the colon wall

Question 11

What is the clinical appearance of ulcerative colitis?

Answer 11

Relapsing attacks of bloody diarrhea with stringy mucoid material, toxic megacolon

Question 12

What histological findings may be found with Crohn’s disease?

Answer 12

Crypt abscesses, noncaseating granulomas

Question 13

What is the gross morphological appearance of Crohn’s disease?

Answer 13

Cobblestone appearance, fistulas or perforations, thickening of the colonic wall, creeping fat

Question 14

What symptoms are generally present with Crohn’s disease?

Answer 14

Acute RLQ pain, diarrhea, fever, iron deficiency anemia, hypoalbuminemia

Question 15

This is a potential complication of pancolitis that involves mild mucosal inflammation of the ileum.

Answer 15

Backwash ileitis

Question 16

What treatment options are available for Crohn’s disease?

Answer 16

Anti-inflammatory agents, immunosuppressive drugs, biologic therapies (anti-TNF)