GPR: 2019 - Week 31

From MGH Learn Pathology

Clinical history

34-year-old male with frequent bloody stools, nausea/vomiting, and abdominal pain despite maximal medical therapy

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Ulcerative colitis
  • Usually involves rectum
  • Extends proximally continuously
  • Can revert to normal mucosa abruptly or gradually
  • Hemorrhagic, granular, friable
  • Can have “cecal patch” (manifestation near the appendiceal orifice)

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Pseudomembranous colitis

  • Colonization with C. diff, release of toxins, mucosal damage
  • Yellow-green exudates adherent to the mucosal surface

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Crohn's disease

  • Usually no rectum involvement
  • Skip lesions
  • Serosa dull/granular with fat wrapping
  • Thick intestinal wall, narrow lumen, fistulas, linear ulcers
  • Sharp demarcation of uninvolved
  • Cobblestone appearance

This week's Gross Pathology Roundup was presented by Melissa Krystel-Whittemore MD on 2019-07-29.