Colon non tumor
Colitis (non-infectious)
Lymphocytic colitis

Author: Hanni Gulwani, M.D. (see Authors page)

Revised: 27 December 2016, last major update May 2013

Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.

PubMed Search: lymphocytic colitis [title] colon

Related topics: Paucicellular variant
Cite this page: Lymphocytic colitis. PathologyOutlines.com website. http://pathologyoutlines.com/topic/colonlymphocytic.html. Accessed May 24th, 2017.
Definition / general
  • "Microscopic colitis" now describes both collagenous colitis and lymphocytic colitis
  • Chronic, nonbloody, water diarrhea, with normal endoscopy in middle aged patients
  • Reported gender predilection varies from equal to female predominance
  • Associated with autoimmune diseases (autoimmune gastritis, celiac sprue [J Clin Gastroenterol 2001;32:225], myasthenia gravis, rheumatoid arthritis, thyroiditis), and a family history of bowel disorders in Sweden (Gut 2004;53:536)
  • Cytotoxic T Lymphocyte distribution pattern differences exist among these CC and LC , differences in the immunologic recruitment of Foxp3+ Tregs in the colonic mucosa (Am J Clin Pathol 2012;137:931)
  • May represent similar disease entity as collagenous colitis
  • Confirm presence of chronic diarrhea before making diagnosis
  • Recent study suggests associated with E coli (World J Gastroenterol 2005;11:7266), and is seasonal (J Clin Gastroenterol 2005;39:891)
  • Increased production of the antibacterial enzyme lysozyme in CC and LC supports a bacterial aetiology for these two diseases; lysozyme upregulation in different cell types (epithelial vs macrophages) supports the notion that CC and LC might be two different maladies (J Clin Pathol 2011;64:510)
Case reports
Treatment
  • Sulfasalazine, corticosteroids
  • Oral budesonide causes a disease relapse after a short-duration treatment (Adv Anat Pathol 2012;19:28)
Microscopic (histologic) description
  • Colonic epithelial lymphocytosis (15 - 20+ per 100 epithelial cells) with surface epithelial damage but without thickened subepithelial collagen; also crypt distortion and increased chronic inflammatory cells in lamina propria; in terminal ileum, 6+ intraepithelial lymphocytes per 100 epithelial cells is 98% specific and 50 - 60% sensitive for collagenous/lymphocytic colitis (Am J Surg Pathol 2002;26:1484)
  • Atypical form of microscopic colitis show morphologic changes similar to chronic IBD or ischemis of infectious colitis (Adv Anat Pathol 2005;12:203)
Microscopic (histologic) images

Images hosted on other servers:
Missing Image

Intraepithelial lymphocytes #1

Missing Image

Intraepithelial lymphocytes #2

Missing Image

Intraepithelial lymphocytes #3

Missing Image

Intraepithelial lymphocytes #4

Missing Image

Intraepithelial lymphocytes #5


Missing Image

Chromogranin A

Missing Image

Classic form

Missing Image

Comparison with collagenous colitis #1

Missing Image

#2 a-lymphocytic colitis
b-collagenous colitis

Missing Image

Tangential colonic biopsy

Positive stains
Differential diagnosis