![]() ![]() It includes a leaky epithelial barrier and a dysregulated immune response towards the intestinal luminal content. The pathophysiology underlying IBD is complex and not completely understood. ![]() CD can in contrast affect any part of the GI tract, and is characterized by discontinued inflammation (skip lesions) with transmural inflammation that leads to fibrosis, fistula and strictures, causing symptoms such as chronic abdominal pain, diarrhea, obstruction or perianal lesions ( 2). The inflammation is mostly superficial and complicated by erosions, ulcers and bloody diarrhea with mucinous stool ( 1). In general, UC affects the colon only and spreads continuously from rectum to more proximal colonic segments. Nevertheless, some overlap in clinical and histopathological manifestations can indeed be seen, which can lead to diagnostic doubt and mix-up of the correct diagnosis. UC and CD differs in pathophysiology, affected parts of the gastrointestinal (GI) tract, symptoms, complications and treatment regimens. Both are chronic remittent diseases, with an increasing incidence worldwide, that are causing severe morbidity and reduced quality of life in affected individuals ( 3, 4). Ulcerative colitis (UC) and Crohn’s disease (CD) encompasses the two major forms of IBD ( 1, 2). The histological examination of surgical specimens or endoscopic biopsies is a central element in establishing a diagnosis of inflammatory bowel disease (IBD). Received: 12 January 2021 Accepted: 19 March 2021 Published: 30 March 2021. Keywords: Histopathology histological remission histological index Crohn’s disease (CD) ulcerative colitis (UC) Given the growing amount of valid data, it might also be beneficial to systematically include use of histological scoring in daily clinical practice to improve the future management of IBD. For now, systematic assessment of histological activity with an appropriate histological index is a well-established endpoint for evaluation of treatment responses in clinical trials. Recent progress in the usage of proper validated histological indexes to measure and grade the histological activity in endoscopic biopsies, and the systematical evaluation of resection margins in ileal resections specimens in CD, suggest that histological assessment can be utilized as a predictive factor that can guide disease management, also after the diagnosis has been established. Though, the fact that no single finding is truly disease specific can introduce diagnostic doubt and mix-up of the diagnoses. The histopathological features that are characteristic for either UC or CD, have been well-described for decades. The histological examination of endoscopic biopsies or resection specimens after surgery aids in establishing the diagnosis of IBD and plays a central part in distinguishing between the two main entities of IBD, that is ulcerative colitis (UC) and Crohn’s disease (CD). Interviews with Outstanding Guest EditorsĪbstract: Optimal management of inflammatory bowel disease (IBD) requires a multidisciplinary team approach, including specialists in the fields of gastroenterology, surgery, radiology and pathology.Policy of Dealing with Allegations of Research Misconduct.Policy of Screening for Plagiarism Process. ![]()
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