Click
on thumbnails to see full sized pictures.Gastrointestinal Pathology- Clinicopathologic Correlation in Mucosal Biopsy
Case #8 (question #12):
A 55 year-old woman, 2 months status post lung transplantation, who developed abdominal pain and diarrhea. She subsequently underwent a segmental resection of the colon. Representative images are illustrated below:
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Question No. 12. The Answer is: (B) It is rarely associated with antibiotic use.
Discussion: These are typical findings of pseudomembranous colitis. The gross photo shows discrete raised indurated creamy-yellow mucosal plaques. Microscopically the discrete plaque represents a small focus of disrupted crypts. The superficial crypts are dilated and filled with degenerative absorptive cells and goblet cells, liberated mucus, fibrin, and acute inflammatory cells. All coalesce to form the yellow plaque. Clostridium difficile and its toxins are the main cause of pseudomembranous colitis. The occurrence of pseudomembranous colitis is generally thought to be commonly associated with antibiotic use. While vascular factors are important in the pathogenesis of pseudomembranous colitis, identical histologic changes can be seen in ischemia from other causes.