Biopsy results interpretation

[enoon]

Hello.
I received my biopsy results from a colonoscopy that was checking for Crohn's. Prior to that the blood-work, stool sample, and CT abdomen test had been consistent with Crohn's. Unfortunately I won't meet with the doctor for a while and curiosity is getting the better of me. If someone understands these things, could you give your opinion on whether you think these results could indicate Crohn's.

"Specimen #1 - Small Intestine (Terminal Ileum), Biopsy:
- Small bowel mucosa with active enteritis with erosion/ulceration, fibrosis, and focal histiocytic aggregate.
- GMS and AFB stains are negative for fungal and acid fast organisms.
- Immunohistochemistry for CD68 highlights the histiocyte aggregate. Pancytokeratin AE1/AE3 shows no evidence of an infiltrative epithelial proliferation."

"Specimen #2 - Colon (Ileocecal Valve), Biopsy:
- Colonic mucosa with focal erosion."

Thanks for any insights.

 

[Scipio]

It basically says that the terminal ileum of your small bowel shows signs of ulcers and inflammation that was apparently not caused by bacterial or fungal infection (in other words it might be Crohn's). There are "focal" (i.e. confined to specific points as opposed to spread all over) clumps of white blood cells. Staining this area with an antibody for the protein CD68 shows that the clumps of cells are a certain type of white blood cell that known to attack and engulf other cells - infected or inflamed cells or bacteria.

Staining for Pancytokeratin AE1/AE3 protein did not show signs of certain types of proteins, sometimes seen in normal tissue or cancer, infiltrating the tissue.

The colon in the vicinity of the ileocecal valve (the border between the small and large bowel) also show confined areas (focal) destruction of tissue.

 

[enoon]

Thanks for that. The clumps of white blood cells... are those granuloma?

 

[Scipio]

Thanks for that. The clumps of white blood cells... are those granuloma?

Possibly, although the pathologist did not specifically use that term. I don't want to put words in his/her mouth. But CD68+ cell are often elevated in numbers in IBD granulomas.