Feature not seen in Crohn's disease:
Ans: c (Pyloric gland hyperplasia)Ref: Robbins 8th ed Pg. 810Crohn's disease is an inflammatory bowel disease is characterized pathologically by:1. Sharply demarcated transmural involvement of the bowel with intervening normal bowel (Skip lesions).2. Non caseating granulomas.3. Fissuring with formation of fistulae.Histologic features of CD is:1. Mucosal inflammation - neutrophilic infiltration Crypt abscess2. Chronic mucosal damage - mucosal metaplasia in the form of:1. Pyloric metaplasia, paneth cell metaplasia.2. Ulcers - fissuring ulcers, fistula.3. Transmural inflammation affecting all layers.4. Non caseating granulomas.Feature Crohn's DiseaseUlcerative ColitisMacroscopic feature 1. Distribution Segmental with skip areasContinuous without skip areas.2. Location Commonly terminal Commonly ileum and/or rectum sigmoid ascending colon colon and extending upwards3. Ulcers Serpiginous ulcers. Superficial that may Fissure mucosal ulcers4. Pseudopolyps Rare Common 5. Fibrosis Common RareMicroscopic features1. Depth of Typically transmural Mucosal and inflammation submucosal2. Type of Non-caseating Crypt abscess inflammation ranulomas3. Mucosa Patchy ulceration Haemorrhagic mucosa with ulceration4. Submucosa Widened due to Normal or edema and reduced in width lymphoid ulceration aggregates5. Muscularis Infiltrated by Usually spared, inflammatory cells except in case of Toxic megacolonComplications1. Fistula More common Rare formation2. Malignant Less common More common Changes3. Toxic -- Present megacolon4. Named Hose pipe Garden hoseFeaturesappearance appearance Cobble- Stone Pseudopolyps appearance
Granulomas
Fissuring ulcers
Pyloric gland hyperplasia
Paneth cell metaplasia
G.I.T.