Pathology of the Gastrointestinal Tract

2017 Edition
| Editors: Fátima Carneiro, Paula Chaves, Arzu Ensari

Lymphocytic Colitis

  • Arzu EnsariEmail author
Reference work entry


Microscopic colitis; Microscopic colitis with intraepithelial lymphocytosis


Lymphocytic colitis (LC) is characterized by a diffuse increase of intraepithelial lymphocytes (IELs) (>20 IELs per 100 epithelial cells) in the surface epithelium accompanied by an increase of lamina propria inflammatory cells. By definition, no subepithelial collagen deposition should be present. The diagnosis of LC should be made in conjunction with clinical, endoscopic, and histological findings. Patients typically present with chronic watery diarrhea with normal or near-normal endoscopy.

Clinical Features

  • Incidence

    The incidence of LC is approximately 3.1 in 100,000.

  • Age

    It is common in middle-aged to older adults with a mean age of 51 years.

  • Sex

    Female predominance is less in LC with nearly equal sex distribution.

  • Site

    There are reports that suggest nonuniform colonic involvement, with less inflammation in the left colon compared with the right colon.

  • Treatment

    Most patients respond to...

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References and Further Reading

  1. Beaugerie, L., Luboinski, J., Brousse, N., et al. (1994). Drug induced lymphocytic colitis. Gut, 35, 426–428.CrossRefGoogle Scholar
  2. Fernández-Bañares, F., Salas, A., Esteve, M., et al. (2003). Collagenous and lympho-cytic colitis: Evaluation of clinical and histological features, response to treatment, and long-term follow-up. The American Journal of Gastroenterology, 98, 340–347.CrossRefGoogle Scholar
  3. Langner C, Aust D, Ensari A, Villanacci V, Becheanu G, Miehlke S, Geboes K, Münch A; Working Group of Digestive Diseases of the European Society of Pathology (ESP) and the European Microscopic Colitis Group (EMCG) (2015) Histology of microscopic colitis-review with a practical approach for pathologists. Histopathology, 66(5), 613–626.CrossRefGoogle Scholar
  4. Lazenby, A. J., Yardley, J. H., Giardiello, F. M., et al. (1989). Lymphocytic (‘microscopic’) colitis: A comparative histopathologic study with particular reference to collagenous colitis. Human Pathology, 20, 18–28.CrossRefGoogle Scholar
  5. Wang, N., Dumot, J. A., Achkar, E., et al. (1999). Colonic epithelial lymphocytosis without a thickened subepithelial collagen table: A clinicopathologic study of 40 cases supporting a heterogeneous entity. The American Journal of Surgical Pathology, 23, 1068–1074.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of PathologyAnkara University Medical SchoolSihhiyeTurkey