Colon
Other nonneoplastic
Vasculitis
Author: Raul S. Gonzalez, M.D.
Last author update: 9 February 2021
Last staff update: 17 February 2021
Copyright: 2003-2024, PathologyOutlines.com, Inc.
PubMed Search: Vasculitis[TI] colon[TIAB]
Table of Contents
Definition / general | Essential features | Epidemiology | Sites | Clinical features | Diagnosis | Radiology images | Clinical images | Microscopic (histologic) images | Sample pathology report | Differential diagnosis | Additional references | Board review style question #1 | Board review style answer #1Cite this page: Gonzalez RS. Vasculitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/colonvasculitis.html. Accessed December 16th, 2024.
Definition / general
- Most systemic vasculitides involving small or medium sized vessels can manifest in the colon or elsewhere in the gastrointestinal tract:
- Medium vessel vasculitides:
- Kawasaki disease (BMJ Case Rep 2013;2013)
- Polyarteritis nodosa (J Gastroenterol 1999;34:400)
- Small vessel vascilitides:
- Behçet disease (Int J Rheum Dis 2013;16:595)
- Buerger disease (Gut Liver 2010;4:287)
- Churg-Strauss syndrome (Hepatogastroenterology 1997;44:1090)
- Cryoglobulinemic vasculitis (Am J Gastroenterol 1991;86:522)
- Henoch-Schönlein purpura (Gastroenterol Res Pract 2010;2010:597648)
- Kohlmeier-Degos disease (Br J Dermatol 1988;118:117)
- Leukocytoclastic vascilitis (Dis Colon Rectum 2005;48:167)
- Microscopic polyangiitis (Ann Rheum Dis 2004;63:1521)
- Systemic lupus erythematosus (Orphanet J Rare Dis 2013;8:67)
- Granulomatosis with polyangiitis (Wegener) (Br J Rheumatol 1998;37:387)
- Medium vessel vasculitides:
Essential features
- Essentially any systemic vasculitis can involve the GI tract, with varying histologic features
Epidemiology
- Depends on particular vasculitis
Sites
- Colon can be affected as well as remainder of gastrointestinal tract
Clinical features
- Colonic manifestations may range from clinically silent to causing intestinal ischemia
Diagnosis
- Small vessel vasculitis may be observed on biopsy, medium vessel vasculitis on resection
Radiology images
Images hosted on other servers:
Occlusion of inferior mesenteric artery
Small intestinal edema
Clinical images
Images hosted on other servers:
Marked narrowing of sigmoid colon
Circumferential sigmoidal ulceration
Inflammation, submucosal hemorrhage, and small ulceration
Hyperemic, edematous colonic mucosa
Microscopic (histologic) images
Contributed by Raul S. Gonzalez, M.D.
Vasculitis
Sample pathology report
- Ascending colon, ulcer, biopsy:
- Colonic mucosa with focal submucosal eosinophilic inflammation surrounding blood vessels, suggestive of involvement by the patient's known Churg-Strauss syndrome
Differential diagnosis
- Main consideration is what form of vasculitis is present
- Requires careful pathologic analysis and clinical correlation
- Crohn’s disease or ulcerative colitis:
- Severe cases of inflammatory bowel disease may show focal inflammation of vessels as part of the overall inflammatory component
- True vasculitis may rarely coexist (Semin Arthritis Rheum 2016;45:475)
Additional references
Board review style question #1
- Which of the following is true about vasculitis involving the gastrointestinal tract?
- It always occurs in the setting of inflammatory bowel disease
- It is sometimes clinically silent
- Medium vessel vasculitides can often be observed on biopsy
- The rest of the gastrointestinal tract is never affected
Board review style answer #1
