Quantifying intraepithelial lymphocytes and subepithelial collagen band in microscopic colitis, extracting insights into the interrelationship of lymphocytic and collagenous colitis

Peter Johan Heiberg Engel*, Anne Marie Kanstrup Fiehn, Danny Goudkade, Jeppe Thagaard, Henrik Holten-Rossing, Stefania Landolfi, Vincenzo Villanacci, Lars Kristian Munck

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Microscopic colitis (MC) is the umbrella term for the conditions termed lymphocytic colitis (LC) and collagenous colitis (CC). LC with thickening of the subepithelial collagen band or CC with increased number of intraepithelial T- lymphocytes (IELs) is often seen in MC and may lead to difficulties in correct histological classification. We investigated the extent of overlapping features of CC and LC in 60 cases of MC by measuring the exact thickness of the subepithelial collagen band in Van Gieson stained slides and quantifying number of IELs in CD3 stained slides by digital image analysis. A thickened collagen band was observed in nine out of 29 cases with LC (31%) and an increased number of IELs in all 23 cases of CC (100%). There was no correlation between the thickness of the collagen band and number of IELs. Due to the increased number of IELs in all cases of CC we consider the lymphocytic inflammatory infiltration of the mucosa to be the essential histopathological feature of MC. However, although LC and CC are related due to the lymphocytic inflammation, the non-linear correlation of number of IELs and thickness of the collagenous band indicate differences in their pathogenesis.

Original languageEnglish
Article number151741
JournalAnnals of Diagnostic Pathology
Volume52
Number of pages6
ISSN1092-9134
DOIs
Publication statusPublished - Jun 2021

Bibliographical note

Funding Information:
The study was funded by Dr. Johan Bohr, Örebro University Hospital , Medicin Kliniken, S-701 85 Örebro, Sweden and Dr. Falk Pharma GMBH , Leinenweberstraße 5, 79108 Freiburg, Germany.

Publisher Copyright:
© 2021 Elsevier Inc.

Keywords

  • Collagenous colitis
  • Digital image analysis
  • Histology
  • Interobserver variation
  • Lymphocytic colitis

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