Sandmeier D, Bouzourene H
Institute of Pathology, Lausanne, Switzerland.
Int J Surg Pathol. 2004 Jan;12(1):45-8. doi: 10.1177/106689690401200107.
Collagenous and lymphocytic colitis might be part of the same disease spectrum. In this report, we present a histopathologic subtype of microscopic colitis characterized by the presence of subepithelial multinucleated giant cells. This reaction is very unusual and not explicable by any underlying disease process or previous treatment. Among 490 cases of microscopic colitis (MC) diagnosed between 1992 and 2002, we found 2 cases with macrophages and giant cells (0.4%). One case of lymphocytic colitis (LC) and 1 case of collagenous colitis (CC) presented aggregates of macrophages and giant cells located in the superficial part of the lamina propria. Infectious or non-infectious colonic granulomatous diseases were excluded on histologic, clinical, and biological grounds. The recognition of this feature in an MC is important to avoid the diagnosis of granulomatous infectious or idiopathic colitis such as Crohn's disease. Even if very unusual, this subtype of MC evolves favorably since the 2 patients responded well to corticosteroid treatment.
胶原性结肠炎和淋巴细胞性结肠炎可能属于同一疾病谱。在本报告中，我们呈现了一种显微镜下结肠炎的组织病理学亚型，其特征为上皮下多核巨细胞的存在。这种反应非常罕见，无法用任何潜在的疾病过程或先前的治疗来解释。在1992年至2002年间诊断的490例显微镜下结肠炎（MC）病例中，我们发现2例有巨噬细胞和巨细胞（0.4%）。1例淋巴细胞性结肠炎（LC）和1例胶原性结肠炎（CC）在固有层浅层出现巨噬细胞和巨细胞聚集。基于组织学、临床和生物学依据排除了感染性或非感染性结肠肉芽肿性疾病。在MC中识别这一特征对于避免诊断为肉芽肿性感染性或特发性结肠炎（如克罗恩病）很重要。即使这种MC亚型非常罕见，但由于这2例患者对皮质类固醇治疗反应良好，其病情进展良好。
