Price A B
J Clin Pathol. 1978 Jun;31(6):567-77. doi: 10.1136/jcp.31.6.567.
It is stated that 10-20% of cases of non-specific inflammatory bowel disease cannot be classified. Thirty such cases, designated colitis indeterminate at the time of colectomy, were identified from the pathology files of St. Mark's Hospital. The Histopathological features of the surgical specimens and any available biopsy specimens were studied. In nearly all the cases urgent surgery had been 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. The specimens gave a dynamic perspective of the disease process, often more valuable than the static, non-specific picture of acute disease seen in the surgical specimens. Case of colitis indeterminate form a small distinctive group in the spectrum of inflammatory bowel disease which is characterised by a common pattern of pathology that presents a diagnostic dilemma.
据称，10% - 20%的非特异性炎性肠病病例无法分类。从圣马克医院的病理档案中识别出30例在结肠切除时被判定为不确定性结肠炎的病例。对手术标本以及任何可用活检标本的组织病理学特征进行了研究。几乎所有病例都需要急诊手术，且存在早期或已确诊的暴发性疾病特征。这些克罗恩病和溃疡性结肠炎病例的病理学表现相互重叠，鉴别特征稀少或不可靠。在后来被证明为溃疡性结肠炎的病例中发现了克罗恩病的公认标准，即裂隙性溃疡、透壁性炎症以及杯状细胞数量保持。疾病活动度极大地影响了形态学特征的评估。当检查静止期获取的活检材料时，许多困难得以解决。这些标本展现了疾病过程的动态视角，往往比手术标本中所见的急性疾病的静态、非特异性图像更有价值。不确定性结肠炎病例在炎性肠病谱系中形成一个独特的小群体，其特征是具有共同的病理模式，这带来了诊断难题。
