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Biopsy help

Ok..here is some info.

Colon, Cecum and Ascending:
Markedly Active Chronic Colitis
Ulcer
No evidence of Dysplasia.

Colon, Desc, and sigmoid
same as above

Rectum,
Moderately active Chron Colitis
No dysplasia.

Comments

Whilst the features are in keeping with a diagnosis of IBD(suggestive of Crohns disease), in light of findings identified within specimens C and E, of marked Ulceration, with minimal crypt distortion, clinical correlation is recommended to exclude a possible infectious etiology.

What does this mean?



Also, Sections C and E, demonstrate the presence of features consistent with a markedly active chronic colitis manifested by the presence of extensive ulceration, minimal crypt distortion and granulomata.



I am looking for clarification, I suppose. The infectious etiology confuses me. She had all the parasite stool tests and they came back negative. And I cant think of any infectious disease that would cause such horrendous perinanal skin tags.


Any guidance would be appreciated.
Thanks!:eek2:
 
Well I will take a crack at the dysplasia stuff. = No pre-cancerous malformation is obvious at this time.

The granuloma are some kind of crystalline shaped scars that are a classic indicator of chronic inflammation.

beyond that it's all Greek to me.
 
Hey Sassy - I did a simple google search on infectious etiology and came up with this link:
'http://www.crohns.org/research/cdc.htm#report

You are going to see a lot about M. paratuberculosis in this article. If you are not yet familiar with the theory - they conjecture that a disease similar to Crohn's disease that is found in Cow's called John's disease is caused by M. paratuberculosis infections of the affected Cow's. They *think* that certain individuals may be affected by drinking cow's milk that is infected with this M. para that does not get filtered out by our pasteurization process. So why is it that everyone doesn't have Crohn's disease then? Because there is also a genetic component to this as well. It is still a theory as far as I know - not been proven. The last IBD conference I attended, the docs referenced a study that was done in Australia where individuals with Crohn's were treated with a triple anitbiotic combination that is thought to treat M. para infections - but the study didn't show good/conclusive results that would prove the theory right. They basically "poo-poo'ed" it in a way was my impression. I just give you this info in case you haven't heard so you'd know what they were talking about in the article.

I'm sorry she is still struggling - hopefully you can ask her GI what all these things mean and they can clarify them for you. I think that part is just written so that maybe the GI could try antibiotic treatment to see if this would assist with her healing process.
 

imisspopcorn

Punctuation Impaired
Crypt distortion means chronic mucuosal injury......Because C-diff can and other bacteria and viral pathogens can cause colitis/IBD symptoms, this might just be standard wording in all pathology reports....Kinda a cover your but statement that the pathologist makes.
Call the GI and double check just so you are not worrying yourself. :)
This is just some info explaining other IBD mimic like diseases.
(Other Causes for Inflammatory Bowel Disease
Infectious causes for IBD generally have a more acute onset and run a shorter course than idiopathic forms of IBD. Bacterial organisms that can produce IBD include Shigella, Salmonella, Campylobacter, and some E. coli. Bacteria are a common cause of acute self-limited colitis - active IBD without chronic changes. Viral etiologies include Norwalk-like virus and rotavirus (small bowel) as well as cytomegalovirus (CMV) and herpes simplex virus in immunocompromised persons. Other causes include chlamydial infection and amebiasis.

Antibiotic associated IBD can occur from therapy with broad spectrum antibiotics leading to overgrowth of Clostridium difficile or other organisms such as Candida. This produces a toxin which causes mucosal damage (pseudomembranous colitis). An IBD can also occur with ischemia. A less common disease is collagenous colitis, which is seen as a chronic watery diarrhea in middle-aged women and is characterized by lymphocytic inflammation of surface epithelium and thickened sub- epithelial collagen table.)
 

fenway1971

Sports Crohnie
Hi Sassy,
Talk to your GI about the report. I agree with other posters that it's probably just a CYA statement from the pathologists. Sounds like you have Crohn's Colitis like me. Granulmas are an indicator of crohns (versus UC).

Peaches - it's Johne's disease. not John's disease. I didn't hurt any cows. :)

Pop - my eyes went blurry reading your post. so many big words! LOL. Medicine needs to come up with simpler terms.
 
Thanks people for your replies. You opened up my eyes a bit.
I will talk to my teen's new GI.

Have any of you had a definitive biopsy report that said, for sure, that you had crohn's or UC? Or are some of them vague?

Could my daughter have had some kind of infection that caused Crohn's?

She was healthy in Oct, then from there, went downhill.

Thanks again for taking the time to clarify~if anything, I'm becoming Crohn's savvy.:tongue:
 

fenway1971

Sports Crohnie
Hi sassy,
My biopsy report was vague. Concluded it was crohn's (rather than UC) only because (a) the inflammation wasn't continuous which isn't the case with UC and (b) i had indications of microgranulomas.

Nobody knows what "causes" crohn's. Some say it's genetic, others say it could be caused by a strand of microbacteria. If we knew what caused it, then it would be easier to cure it. Instead, we just treat the symptoms.

It can creep up on you. I wasn't diagnosed until I was 31.

Good luck to you and your daughter.
 
I got to see the pathology report from my operation. It was on the Appendix, Ceacum and associated ileum and colon removed.

It said something to the effect of pronounced scaring and heavy concentration of Granuloma indicative of chronic inflammation associated with Crohn's disease for my appendix and caecum. It also went into the condition of the margins of intestine.

My Surgeon went over it with me in his office last month. The diagnosis is really just matching a patient with a set of established criteria. Like Fenway says there is not really anything people can pinpoint with this disease. I often think we would be better off referring to it as a condition.
 
sassychic said:
Thanks people for your replies. You opened up my eyes a bit.
I will talk to my teen's new GI.

Have any of you had a definitive biopsy report that said, for sure, that you had crohn's or UC? Or are some of them vague?

Could my daughter have had some kind of infection that caused Crohn's?

She was healthy in Oct, then from there, went downhill.

Thanks again for taking the time to clarify~if anything, I'm becoming Crohn's savvy.:tongue:
The report from the pathologist usually does not have a diagnosis, the physician correlates the path report with the patients symptoms to make a diagnosis and then discuses this with the patient. They also rule out infection vs disease however an infection does not cause Crohns. There are indicators that r/o one vs the other. Sit down with the md and ask your questions. I had a similar story I was "fine" or so I thought and within 2 months I had what felt like 700 tests and then was admitted to the hospital for 7 nights.
 
fenway1971 said:
Peaches - it's Johne's disease. not John's disease. I didn't hurt any cows. :)
Oopsie! You caught me being lazy and not looking it up to confirm. You just told everyone your first name.....;)
 
Thanks again for the advice. I will contact her doctor and discuss things. I will accept her condition as Crohn's until told otherwise.

Off to do more research!
Hugz to all of you. You are all great!:)
 
Sassy your a great mom , good luck with your research hope your daughters doing ok.

Thanks Peaches and Pop all that helped me out a great deal for myself , you to Kenny
 
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