By Talbot, Ian
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Additional info for Biopsy Pathology in Colorectal Disease, 2Ed
19 Isolated cystically dilated crypt, containing a few polymorphs and debris from a patient with diverticular disease. 5 Crypt dilatation The isolated cystic crypt is not uncommon in what may otherwise be a normal biopsy. Such crypts contain small numbers of polymorphs (Fig. 19). The pathogenesis is uncertain but it is most likely caused by obstruction of the mouth of the crypt by mucus. We are not aware that, in its own right, this is a helpful sign but it is an indication to examine deeper levels for other pathology.
Some of the cells may display features resembling an infection by cytomegalovirus. There is generally an overlying layer of fibrino-purulent exudate. 55 Haemorrhage into lamina propria. Although an artefact, this is often the result of rupturing of congested capillaries in ischaemia or, as in this case, infective colitis. The muscularis mucosae is not a source of useful diagnostic information. A few abnormal patterns are recognized, namely thickening, fibrosis and splaying of fibres into the mucosa.
No diagnostic or prognostic role has been established for the observation of increased numbers of mast cells in inflammatory bowel disease. Large numbers are characteristically found in the large intestinal mucosa and in many tissues, in systemic mastocytosis. 7 Proportions of inflammatory cells The number of neutrophil polymorphs probably reflects the degree of epithelial damage that is taking place. Neutrophils are therefore predominant in acute colitis (Fig. , Chapter 4), and in the active phases of ulcerative colitis, however long the history (Chapter 5).
Biopsy Pathology in Colorectal Disease, 2Ed by Talbot, Ian