Lisa - About Your Pathology Report Dilemma

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tex
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Lisa - About Your Pathology Report Dilemma

Post by tex »

Lisa,

I don't remember if I listed any reference on this for you or not, but in case I didn't, here's a reference on what I'm talking about with paucicellular LC:
Two recent studies found that patients with only increased lymphoplasmacytic inflammation of the lamina propria without increased surface IELs (termed microscopic colitis not otherwise specified) had clinicopathologic relationships similar to those of patients with classic LC.[19,20] Although some authors recommend that the term colonic epithelial lymphocytosis be used for cases that do not fulfill all clinicopathologic criteria of classic LC,[21,22] the similarities in clinicopathologic associations between the paucicellular and classic LC groups lead us to suggest that they be grouped together as one entity.
IOW, this is saying that you don't have to have an increased lymphocyte count in the enterocyte layer of the epithelia in the colon, to qualify for a diagnosis of LC. Inflammation due to lymphocytes in the lamina propria is sufficient.

Also, be aware that many GI departments/hospitals have a very poor record of diagnosing MC, compared with others. Consider this:
RESULTS: The number of patients diagnosed at each hospital ranged between zero and 30, with a median of six. Sixty-eight patients had histological slides reviewed. The numbers of patients with a final reviewed diagnosis of collagenous colitis, lymphocytic colitis and microscopic colitis, type undesignated, were 37, 18 and seven respectively. In thirty-one patients (34%) there was a recent history of the use of non-steroidal anti-inflammatory drugs.

CONCLUSIONS: These data confirm that there is wide hospital variation in the diagnosis of microscopic colitis. Furthermore, the small group with the undesignated type may be associated with the use of non-steroidal anti-inflammatory drugs.
The red emphasis is mine, of course. Note that this report suggests that if your MC was caused by the use of NSAIDS, then that probably increases your chances of being misdiagnosed with an "unspecified type of colitis". How abut that?

I hope this information will be helpful.

http://www.ncbi.nlm.nih.gov/pubmed/12439114

Tex
:cowboy:

It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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