Influence of Sampling Strategy and Utility of Rectal Biopsy in the Diagnosis of Collagenous and Lymphocytic Colitis.

Jonathan N. Glickman, Miraca Life Sciences Research Institute, Irving, TX

Collagenous colitis (CC) and lymphocytic colitis (LC) are chronic watery diarrheal disorders that most commonly affect middle aged to elderly adults. Since the colonic mucosa in each disorder appears endoscopically normal, the diagnosis rests upon characteristic histologic findings in mucosal biopsies. However, the histologic distinction between LC and CC, and between CC/LC and other types of colitis, can be challenging. Typically, multiple random colonic mucosal biopsies are taken for patients with suspected CC and LC, and the diagnosis is based upon cumulative evaluation of multiple fragments. However, the influence of biopsy sampling strategy on diagnostic accuracy for CC and LC is poorly understood, and the utility of rectal biopsies in evaluation of these disorders is not known.

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