HISTOLOGY REPORT
Clinical Details: Subtotal colectomy for ulcerative colitis. Not responding to treatment.
Macroscopic: Length of large bowel 1220 mm with appendix 60 mm and terminal ileum 21 mm. On opening the distal 820 mm is ulcerated with extensive pseudopolyp formation.
Microscopic: The large bowel shows extensive mucosal ulceration with pseudopolyp formation. In places the ulcers are deep extending into the muscularis propria and in one area there is no muscle separating the ulcer from the subserosal tissues. The remaining mucosa shows areas of architectural distortion and mild mucin depletion which increases in severity distally. The lamina propria comprises a mixed lymphoplasmacytic infiltrate with active inflammation, cryptitis and crypt abscesses. There is abundant granulation tissue. The terminal ileum and the appendix do not show any significant abnormalities. Three lymph nodes are identified and these show reactive changes. There is no evidence of amoebae, CMV inclusions, granulomas, dysplasia or malignancy. There is no transmural lymphoid inflammation.
Conclusion: Subtotal colectomy - fulminant ulcerative colitis.