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The Pathology of Chronic Inflammatory Bowel Disease

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Pediatric Inflammatory Bowel Disease

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References

  1. Xin, W., P.I. Brown and J.K. Greenson, The clinical significance of focal active colitis in pediatric patients. Am J Surg Pathol, 2003. 27(8): 1134–8.

    Article  PubMed  Google Scholar 

  2. Withers, G.D. and R.B. Scott, Drug-induced bowel injury, in Pediatric Gastrointestinal Disease, W.W.A., et al., Editors. 2000, B C Decker: Hamilton, Ontario. pp. 788–795.

    Google Scholar 

  3. Zwas, F.R., N.W. Cirillo, H.B. el-Serag, et al., Colonic mucosal abnormalities associated with oral sodium phosphate solution. Gastrointest Endosc, 1996. 43(5): 463–6.

    Article  PubMed  CAS  Google Scholar 

  4. Driman, D.K. and H.G. Preiksaitis, Colorectal inflammation and increased cell proliferation associated with oral sodium phosphate bowel preparation solution. Hum Pathol, 1998. 29(9): 972–8.

    Article  PubMed  CAS  Google Scholar 

  5. Watts, D.A., A.M. Lessells, I.D. Penman, et al., Endoscopic and histologic features of sodium phosphate bowel preparation-induced colonic ulceration: case report and review. Gastrointest Endosc, 2002. 55(4): 584–7.

    Article  PubMed  Google Scholar 

  6. Leriche, M., G. Devroede, G. Sanchez, et al., Changes in the rectal mucosa induced by hypertonic enemas. Dis Colon Rectum, 1978. 21(4): 227–36.

    Article  PubMed  CAS  Google Scholar 

  7. Jonas, G., A. Mahoney, J. Murray, et al., Chemical colitis due to endoscope cleaning solutions: a mimic of pseudomembranous colitis. Gastroenterology, 1988. 95(5): 1403–8.

    PubMed  CAS  Google Scholar 

  8. Lowichik, A. and A.G. Weinberg, A quantitative evaluation of mucosal eosinophils in the pediatric gastrointestinal tract. Mod Pathol, 1996. 9: 110–114.

    PubMed  CAS  Google Scholar 

  9. Pascal, R.R., T.L. Gramlich, K.M. Parker, et al., Geographic variations in eosinophil concentration in normal colonic mucosa. Mod Pathol, 1997. 10(4): 363–5.

    PubMed  CAS  Google Scholar 

  10. Riddell, R.H., Pathology of idiopathic inflammatory bowel disease, in Inflammatory Bowel Disease, J.B. Kirsner and R.G. Shorter, Editors. 1995, Williams and Wilkins: Baltimore. pp. 517–554.

    Google Scholar 

  11. Griffiths, A.M. and P.M. Sherman, Colonoscopic surveillance for cancer in ulcerative colitis: a critical review. J Pediatr Gastroenterol Nutr, 1997. 24(2): 202–210.

    Article  PubMed  CAS  Google Scholar 

  12. Ekbom, A., C. Helmick, M. Zack, et al., Ulcerative colitis and colorectal cancer. A population-based study. N Engl J Med, 1990. 323(18): 1228–1233.

    Article  PubMed  CAS  Google Scholar 

  13. Markowitz, J., M. McKinley, E. Kahn, et al., Endoscopic screening for dysplasia and mucosal aneuploidy in adolescents and young adults with childhood onset colitis. Am J Gastroenterol, 1997. 92(11): 2001–6.

    PubMed  CAS  Google Scholar 

  14. Blackstone, M.O., R.H. Riddell, B.H. Rogers, et al., Dysplasia-associated lesion or mass (DALM) detected by colonoscopy in long-standing ulcerative colitis: an indication for colectomy. Gastroenterology, 1981. 80(2): 366–74.

    PubMed  CAS  Google Scholar 

  15. Keller, K.M., S.W. Bender, H. Kirchmann, et al., Diagnostic significance of epithelioid granulomas in Crohn disease in children. Multicenter Paediatric Crohn Disease Study Group. J Pediatr Gastroenterol Nutr, 1990. 10(1): 27–32.

    Article  PubMed  CAS  Google Scholar 

  16. Schmitz-Moormann, P., P.M. Pittner and M. Sangmeister, Probability of detecting a granuloma in a colorectal biopsy of Crohn disease. Pathol Res Pract, 1984. 178(3): 227–9.

    PubMed  CAS  Google Scholar 

  17. Schmitz-Moormann, P. and M. Schag, Histology of the lower intestinal tract in Crohn disease of children and adolescents. Multicentric Paediatric Crohn Disease Study. Pathol Res Pract, 1990. 186(4): 479–84.

    PubMed  CAS  Google Scholar 

  18. Markowitz, J., E. Kahn and F. Daum, Prognostic significance of epithelioid granulomas found in rectosigmoid biopsies at the initial presentation of pediatric Crohn disease. J Pediatr Gastroenterol Nutr, 1989. 9(2): 182–6.

    PubMed  CAS  Google Scholar 

  19. Shepherd, N.A., Granulomas in the diagnosis of intestinal Crohn disease: a myth exploded? Histopathology, 2002. 41(2): 166–8.

    Article  PubMed  CAS  Google Scholar 

  20. Pulimood, A.B., B.S. Ramakrishna, G. Kurian, et al., Endoscopic mucosal biopsies are useful in distinguishing granulomatous colitis due to Crohn disease from tuberculosis. Gut, 1999. 45(4): 537–41.

    PubMed  CAS  Google Scholar 

  21. El-Maraghi, N.R. and N.S. Mair, The histopathology of enteric infection with Yersinia pseudotuberculosis. Am J Clin Pathol, 1979. 71(6): 631–9.

    PubMed  CAS  Google Scholar 

  22. Isaacs, D., V.M. Wright, D.G. Shaw, et al., Chronic granulomatous disease mimicking Crohn disease. J Pediatr Gastroenterol Nutr, 1985. 4(3): 498–501.

    PubMed  CAS  Google Scholar 

  23. Schappi, M.G., V.V. Smith, D. Goldblatt, et al., Colitis in chronic granulomatous disease. Arch Dis Child, 2001. 84(2): 147–51.

    Article  PubMed  CAS  Google Scholar 

  24. Schumacher, G., First attack of inflammatory bowel disease and infectious colitis. A clinical, histological and microbiological study with special reference to early diagnosis. Scand J Gastroenterol Suppl, 1993. 198: 1–24.

    Google Scholar 

  25. Konuma, Y., M. Tanaka, H. Saito, et al., A study of the histological criteria for ulcerative colitis: retrospective evaluation of multiple colonic biopsies. J Gastroenterol, 1995. 30(2): 189–94.

    Article  PubMed  CAS  Google Scholar 

  26. Glickman, J.N., A. Bousvaros, F.A. Farraye, et al., Pediatric patients with untreated ulcerative colitis may present initially with unusual morphologic findings. Am J Surg Pathol, 2004. 28(2): 190–7.

    Article  PubMed  Google Scholar 

  27. Escher, J.C., K.F. Ten, K. Lichtenbelt, et al., Value of rectosigmoidoscopy with biopsies for diagnosis of inflammatory bowel disease in children. Inflamm Bowel Dis, 2002. 8(1): 16–22.

    Article  PubMed  Google Scholar 

  28. Markowitz, J., E. Kahn, K. Grancher, et al., Atypical rectosigmoid histology in children with newly diagnosed ulcerative colitis. Am J Gastroenterol, 1993. 88(12): 2034–7.

    PubMed  CAS  Google Scholar 

  29. Robert, M.E., M. Skacel, T. Ullman, et al., Patterns of colonic involvement at initial presentation in ulcerative colitis: a retrospective study of 46 newly diagnosed cases. Am J Clin Pathol, 2004. 122(1): 94–9.

    Article  PubMed  Google Scholar 

  30. Washington, K., J.K. Greenson, E. Montgomery, et al., Histopathology of ulcerative colitis in initial rectal biopsy in children. Am J Surg Pathol, 2002. 26(11): 1441–9.

    Article  PubMed  Google Scholar 

  31. Robert, M.E., L. Tang, L.M. Hao, et al., Patterns of inflammation in mucosal biopsies of ulcerative colitis: perceived differences in pediatric populations are limited to children younger than 10 years. Am J Surg Pathol, 2004. 28(2): 183–9.

    Article  PubMed  CAS  Google Scholar 

  32. Jenkins, D., M. Balsitis, S. Gallivan, et al., Guidelines for the initial biopsy diagnosis of suspected chronic idiopathic inflammatory bowel disease. The British Society of Gastroenterology Initiative. J Clin Pathol, 1997. 50(2): 93–105.

    Article  PubMed  CAS  Google Scholar 

  33. Nostrant, T., N. Kumar and H. Appelman, Histopathology diffentiates acute self-limited colitis from ulcerative colitis. Gastroenterology, 1987. 92: 318–328.

    PubMed  CAS  Google Scholar 

  34. Dundas, S.A., J. Dutton and P. Skipworth, Reliability of rectal biopsy in distinguishing between chronic inflammatory bowel disease and acute self-limiting colitis. Histopathology, 1997. 31(1): 60–6.

    Article  PubMed  CAS  Google Scholar 

  35. Tanaka, M., R.H. Riddell, H. Saito, et al., Morphologic criteria applicable to biopsy specimens for effective distinction of inflammatory bowel disease from other forms of colitis and of Crohn disease from ulcerative colitis. Scand J Gastroenterol, 1999. 34(1): 55–67.

    Article  PubMed  CAS  Google Scholar 

  36. Faubion, W.A., Jr., E.V. Loftus, W.J. Sandborn, et al., Pediatric “PSC-IBD”: a descriptive report of associated inflammatory bowel disease among pediatric patients with psc. J Pediatr Gastroenterol Nutr, 2001. 33(3): 296–300.

    Article  PubMed  Google Scholar 

  37. Kim, B., J.L. Barnett, C.G. Kleer, et al., Endoscopic and histological patchiness in treated ulcerative colitis. Am J Gastroenterol, 1999. 94(11): 3258–62.

    Article  PubMed  CAS  Google Scholar 

  38. Kleer, C.G. and H.D. Appelman, Ulcerative colitis: patterns of involvement in colorectal biopsies and changes with time. Am J Surg Pathol, 1998. 22(8): 983–9.

    Article  PubMed  CAS  Google Scholar 

  39. Geboes, K. and I. Dalle, Influence of treatment on morphological features of mucosal inflammation. Gut, 2002. 50(Suppl 3): III37–42.

    Article  PubMed  Google Scholar 

  40. Gledhill, A., M.E. Enticott and S. Howe, Variation in the argyrophil cell population of the rectum in ulcerative colitis and adenocarcinoma. J Pathol, 1986. 149(4): 287–91.

    Article  PubMed  CAS  Google Scholar 

  41. Heuschen, U.A., U. Hinz, E.H. Allemeyer, et al., Backwash ileitis is strongly associated with colorectal carcinoma in ulcerative colitis. Gastroenterology, 2001. 120(4): 841–7.

    Article  PubMed  CAS  Google Scholar 

  42. Alexander, F., S. Sarigol, J. Difiore, et al., Fate of the pouch in 151 pediatric patients after ileal pouch anal anastomosis. J Pediatr Surg, 2003. 38(1): 78–82.

    Article  PubMed  Google Scholar 

  43. Haskell, H., C.W. Andrews, Jr., S.I. Reddy, et al., Pathologic features and clinical significance of “backwash” ileitis in ulcerative colitis. Am J Surg Pathol., 2005. 29(11): 1472–81.

    Article  PubMed  Google Scholar 

  44. Koukoulis, G.K., Y. Ke, J.D. Henley, et al., Detection of pyloric metaplasia may improve the biopsy diagnosis of Crohn ileitis. J Clin Gastroenterol, 2002. 34(2): 141–3.

    Article  PubMed  Google Scholar 

  45. Gustavsson, S., L.H. Weiland and K.A. Kelly, Relationship of backwash ileitis to ileal pouchitis after ileal pouch-anal anastomosis. Dis Colon Rectum, 1987. 30(1): 25–8.

    Article  PubMed  CAS  Google Scholar 

  46. Gryboski, J.D., J. Burger, R. McCallum, et al., Gastric emptying in childhood inflammatory bowel disease: nutritional and pathologic correlates. Am J Gastroenterol, 1992. 87(9): 1148–53.

    PubMed  CAS  Google Scholar 

  47. Kaufman, S.S., J.A. Vanderhoof, R. Young, et al., Gastroenteric inflammation in children with ulcerative colitis. Am J Gastroenterol, 1997. 92(7): 1209–12.

    PubMed  CAS  Google Scholar 

  48. Lenaerts, C., C.C. Roy, M. Vaillancourt, et al., High incidence of upper gastrointestinal tract involvement in children with Crohn disease. Pediatrics, 1989. 83(5): 777–781.

    PubMed  CAS  Google Scholar 

  49. Wright, C.L. and R.H. Riddell, Histology of the stomach and duodenum in Crohn disease. Am J Surg Pathol, 1998. 22(4): 383–90.

    Article  PubMed  CAS  Google Scholar 

  50. Tobin, J.M., B. Sinha, P. Ramani, et al., Upper gastrointestinal mucosal disease in pediatric Crohn disease and ulcerative colitis: a blinded, controlled study. J Pediatr Gastroenterol Nutr, 2001. 32(4): 443–8.

    Article  PubMed  CAS  Google Scholar 

  51. Abdullah, B.A., S.K. Gupta, J.M. Croffie, et al., The role of esophagogastroduodenoscopy in the initial evaluation of childhood inflammatory bowel disease: a 7-year study. J Pediatr Gastroenterol Nutr, 2002. 35(5): 636–40.

    Article  PubMed  Google Scholar 

  52. Valdez, R., H.D. Appelman, M.P. Bronner, et al., Diffuse duodenitis associated with ulcerative colitis. Am J Surg Pathol, 2000. 24(10): 1407–13.

    Article  PubMed  CAS  Google Scholar 

  53. Kundhal, P.S., M.O. Stormon, M. Zachos, et al., Gastral antral biopsy in the differentiation of pediatric colitides. Am J Gastroenterol, 2003. 98(3): 557–61.

    Article  PubMed  CAS  Google Scholar 

  54. Parente, F., C. Cucino, S. Bollani, et al., Focal gastric inflammatory infiltrates in inflammatory bowel diseases: prevalence, immunohistochemical characteristics, and diagnostic role. Am J Gastroenterol, 2000. 95(3): 705–11.

    Article  PubMed  CAS  Google Scholar 

  55. Sharif, F., M. McDermott, M. Dillon, et al., Focally enhanced gastritis in children with Crohn disease and ulcerative colitis. Am J Gastroenterol, 2002. 97(6): 1415–20.

    Article  PubMed  CAS  Google Scholar 

  56. Pascasio, J.M., S. Hammond and S.J. Qualman, Recognition of Crohn disease on incidental gastric biopsy in childhood. Pediatr Dev Pathol, 2003. 6(3): 209–14. Epub 2003 Mar 28.

    Article  PubMed  Google Scholar 

  57. Goldblum, J.R. and H.D. Appelman, Appendiceal involvement in ulcerative colitis. Modern pathology: an official journal of the United States and Canadian Academy of Pathology, Inc., 1992; Vol. 5(6), pp. 607–10.

    CAS  Google Scholar 

  58. Groisman, G.M., J. George and N. Harpaz, Ulcerative appendicitis in universal and nonuniversal ulcerative colitis. Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc., 1994; Vol. 7(3), pp. 322–5.

    CAS  Google Scholar 

  59. Kroft, S.H., S.J. Stryker and M.S. Rao, Appendiceal involvement as a skip lesion in ulcerative colitis. Modern pathology: an official journal of the United States and Canadian Academy of Pathology, Inc., 1994; Vol. 7(9), pp. 912–4.

    CAS  Google Scholar 

  60. Perry, W.B., F.G. Opelka, D. Smith, et al., Discontinuous appendiceal involvement in ulcerative colitis: pathology and clinical correlation. Journal of gastrointestinal surgery: official journal of the Society for Surgery of the Alimentary Tract., 1999; Vol. 3(2), pp. 141–4.

    CAS  Google Scholar 

  61. D’Haens, G., K. Geboes, M. Peeters, et al., Patchy cecal inflammation associated with distal ulcerative colitis: a prospective endoscopic study. Am J Gastroenterol, 1997. 92(8): 1275–9.

    PubMed  CAS  Google Scholar 

  62. Okawa, K., T. Aoki, K. Sano, et al., Ulcerative colitis with skip lesions at the mouth of the appendix: a clinical study. Am J Gastroenterol, 1998. 93(12): 2405–10.

    Article  PubMed  CAS  Google Scholar 

  63. Matsumoto, T., S. Nakamura, M. Shimizu, et al., Significance of appendiceal involvement in patients with ulcerative colitis. Gastrointest Endosc, 2002. 55(2): 180–5.

    Article  PubMed  Google Scholar 

  64. Yang, S.K., H.Y. Jung, G.H. Kang, et al., Appendiceal orifice inflammation as a skip lesion in ulcerative colitis: an analysis in relation to medical therapy and disease extent. Gastrointestinal endoscopy., 1999; Vol. 49(6), pp. 743–7.

    Article  PubMed  CAS  Google Scholar 

  65. Kahn, E., J. Markowitz and F. Daum, The appendix in inflammatory bowel disease in children. Mod Pathol, 1992. 5(4): 380–3.

    PubMed  CAS  Google Scholar 

  66. Fazio, V.W., Toxic megacolon in ulcerative colitis and Crohn colitis. Clin Gastroenterol, 1980. 9(2): 389–407.

    PubMed  CAS  Google Scholar 

  67. Swan, N.C., J.G. Geoghegan, D.P. O’Donoghue, et al., Fulminant colitis in inflammatory bowel disease: detailed pathologic and clinical analysis. Dis Colon Rectum, 1998. 41(12): 1511–5.

    Article  PubMed  CAS  Google Scholar 

  68. Price, A.B., Overlap in the spectrum of non-specific inflammatory bowel disease–‘colitis indeterminate’. J Clin Pathol, 1978. 31(6): 567–77.

    Article  PubMed  CAS  Google Scholar 

  69. Shivananda, S., J. Lennard-Jones, R. Logan, et al., Incidence of inflammatory bowel disease across Europe: is there a difference between north and south? Results of the European Collaborative Study on Inflammatory Bowel Disease (EC-IBD). Gut, 1996. 39(5): 690–7.

    Article  PubMed  CAS  Google Scholar 

  70. Silverberg, M.S., J. Satsangi, T. Ahmad, et al., Toward an integrated clinical, molecular and serological classification of inflammatory bowel disease: Report of a Working Party of the 2005 Montreal World Congress of Gastroenterology. Can J Gastroenterol, 2005. 19(Suppl A): 5–36.

    PubMed  Google Scholar 

  71. Mamula, P., G.W. Telega, J.E. Markowitz, et al., Inflammatory bowel disease in children 5 years of age and younger. Am J Gastroenterol, 2002. 97(8): 2005–10.

    Article  PubMed  Google Scholar 

  72. Lindberg, E., B. Lindquist, L. Holmquist, et al., Inflammatory bowel disease in children and adolescents in Sweden, 1984–1995. J Pediatr Gastroenterol Nutr, 2000. 30(3): 259–64.

    Article  PubMed  CAS  Google Scholar 

  73. Meucci, G., A. Bortoli, F.A. Riccioli, et al., Frequency and clinical evolution of indeterminate colitis: a retrospective multi-centre study in northern Italy. GSMII (Gruppo di Studio per le Malattie Infiammatorie Intestinali). Eur J Gastroenterol Hepatol, 1999. 11(8): 909–13.

    Article  PubMed  CAS  Google Scholar 

  74. Wells, A.D., I. McMillan, A.B. Price, et al., Natural history of indeterminate colitis. Br J Surg, 1991. 78(2): 179–81.

    Article  PubMed  CAS  Google Scholar 

  75. Marcello, P.W., D.J. Schoetz, Jr., P.L. Roberts, et al., Evolutionary changes in the pathologic diagnosis after the ileoanal pouch procedure. Dis Colon Rectum, 1997. 40(3): 263–9.

    Article  PubMed  CAS  Google Scholar 

  76. Atkinson, K.G., D.A. Owen and G. Wankling, Restorative proctocolectomy and indeterminate colitis. Am J Surg, 1994. 167(5): 516–8.

    Article  PubMed  CAS  Google Scholar 

  77. Koltun, W.A., D.J. Schoetz, Jr., P.L. Roberts, et al., Indeterminate colitis predisposes to perineal complications after ileal pouch-anal anastomosis. Dis Colon Rectum, 1991. 34(10): 857–60.

    Article  PubMed  CAS  Google Scholar 

  78. Yu, C.S., J.H. Pemberton and D. Larson, Ileal pouch-anal anastomosis in patients with indeterminate colitis: long-term results. Dis Colon Rectum, 2000. 43(11): 1487–96.

    Article  PubMed  CAS  Google Scholar 

  79. Rudolph, W.G., S.M. Uthoff, T.L. McAuliffe, et al., Indeterminate colitis: the real story. Dis Colon Rectum, 2002. 45(11): 1528–34.

    Article  PubMed  Google Scholar 

  80. Stallmach, A., C. Moser, R. Hero-Gross, et al., Pattern of mucosal adaptation in acute and chronic pouchitis. Dis Colon Rectum, 1999. 42(10): 1311–7.

    Article  PubMed  CAS  Google Scholar 

  81. Antonioli, D., Colitis in Infants and Children, in Gastrointestinal Diseases, B. Dahms and S. Qualman, Editors. 1997, Karger: Basel. pp. 77–110.

    Google Scholar 

  82. Apel, R., Z. Cohen, C.W. Andrews, Jr., et al., Prospective evaluation of early morphological changes in pelvic ileal pouches. Gastroenterology, 1994. 107(2): 435–43.

    PubMed  CAS  Google Scholar 

  83. Goldstein, N.S., W.W. Sanford and J.H. Bodzin, Crohn-like complications in patients with ulcerative colitis after total proctocolectomy and ileal pouch-anal anastomosis. Am J Surg Pathol, 1997. 21(11): 1343–53.

    Article  PubMed  CAS  Google Scholar 

  84. Sandborn, W.J., Pouchitis following ileal pouch-anal anastomosis: definition, pathogenesis, and treatment. Gastroenterology, 1994. 107(6): 1856–60.

    PubMed  CAS  Google Scholar 

  85. Horton, K., B. Jones and E. Fishman, Imaging of the inflammatory bowel diseases, in Inflammatory Bowel Disease, fifth edition, J. Kirsner, Editor. 2000, WB Saunders: Phildelphia. pp. 479–500.

    Google Scholar 

  86. Warren, B.F. and N.A. Shepherd, The role of pathology in pelvic ileal reservoir surgery. Int J Colorectal Dis, 1992. 7(2): 68–75.

    Article  PubMed  CAS  Google Scholar 

  87. Setti Carraro, P.G., I.C. Talbot and J.R. Nicholls, Patterns of distribution of endoscopic and histological changes in the ileal reservoir after restorative proctocolectomy for ulcerative colitis. A long-term follow-up study. Int J Colorectal Dis, 1998. 13(2): 103–7.

    Article  PubMed  CAS  Google Scholar 

  88. Lohmuller, J.L., J.H. Pemberton, R.R. Dozois, et al., Pouchitis and extraintestinal manifestations of inflammatory bowel disease after ileal pouch-anal anastomosis. Ann Surg, 1990. 211(5): 622–7; discussion 627–9.

    PubMed  CAS  Google Scholar 

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Russo, P. (2008). The Pathology of Chronic Inflammatory Bowel Disease. In: Mamula, P., Markowitz, J.E., Baldassano, R.N. (eds) Pediatric Inflammatory Bowel Disease. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-73481-1_19

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