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Pathology of Ulcerative Colitis H. Taniguchi 1 1Department of Pathology, The Center for Adult Diseases pp.1015-1022
Published Date 1976/8/25
DOI https://doi.org/10.11477/mf.1403107383
  • Abstract
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 Despite the recent developement of medical technology for diagnosis and many reports of clinical studies including the morphological information and research, some of the inflammatory diseases of the large bowel are still remaining in the name as “non-specific” or “idiopathic” for a longstanding history. Ulcerative colitis is also understood as a chronic inflammatory disorder of the large bowel with uncertain origin, which diffusely affect the mucosa combined with shallow ulcers, but the pathology as to what the inflammation trigger is and what factors influence the course of the disease, is still unknown. Therefore, the diagnosis of ulcerative colitis should be made only when the other diseases were ruled out and only when it is enough characteristic for the ulcerative colitis previously reported.

 Though many papers have been reported on the morphological change of ulcerative colitis, important things in the diagnosis are the differentiation from Crohn's disease of the large bowel, amebiasis of the colon and colonic tuberculosis especially in Japan. In this study, 2 cases of the resected colon with ulcerative colitis were examined in detail both macroscopically and microscopically with comparative studies on the above colonic diseases.

 The histological characteristics of ulcerative colitis are capillarectasis with proliferation, massive infiltration of plasma cells, infiltration of neutrophils, decrease of epithelial goblet cells and crypt abscess. These changes are seen diffusely in the affected colonic mucosa. Above all, the most important is crypt abscess, which appears more frequently in the severely affected portion, and even in mildly affected mucosa, infiltration of the inflammatory cells are seen into the interepithelial space of the crypt, where dissociation between gland and the surrounding interstitium occurs dur to edema. The appeared inflammatory cells were mainly neutrophils in crypt abscess, but plasma cells, lymphocytes and eosinophils were more dominant in the affected mucosa entirely. Crypt abscess was also recognized in the colonic tuberculosis and Crohn's disease of the colon, but the frequency is much rare, and the epithel which encapsulated the abscess was more vivid in tuberculosis than that in ulcerative colitis.

 Mucosal surface of cobble-stone appearance in Crohn's disease was glossy, while granular appearance fo the affected portion with remaining mucosa in ulcerative colitis is rather rough due to the inflammatory change.

 Biopsic examination in ulcerative colitis is quite useful, because degree of the inflammation in the histological findings generally co-insides with the severeness of the clinical state. Therefore, in the follow-up examination, it is possible to predict more precisely whether it is exacerbating, remitting or remaining in quiescence.

 For the pathogenesis of ulcerative colitis, Dr. Uda's work on the relationship between serum immunoglobulin level and the fluorescent microscopic findings of immunoglobulin in the affected colonic mucosa by using fluorescent antibody technic, and also with the electron microscopic findings, was introduced.


Copyright © 1976, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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