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Collagenous Colitis
Etiology

Unknown
Pathogenesis

Unknown. However, three unproven postulates have been suggested: an autoimmune process; a primary inflammatory process to a yet unknown pathogen; and an acquired defect in collagen metabolism.,
Epidemiology

There is a predominance of middle aged females(mean 54 yrs.)
General Gross Description

The colon mucosa is usually normal but may show some evidence of edema and erythema
•Examples:
General Microscopic Description

The pathognomonic lesion is is thickening of the subepithelial collagen layer (SCL)
The SCL has a mean thickening of 15.0 um vs. a normal SCL of 2.5 um
The SCL in collagenous colitis is least thickened in the rectum
The surface epithelium usually show a variable patchy lymphocytic infiltrate with variable degenerative changes which include loss of mucin, flattening, karyorrhexis and lifting of the surface epithelium
The crypts may contain intrapithelial lymphocytes but show no degenerative changes
The lamina propria has increased lymphocytes and mononuclear cells but these are too non-specific to be useful as a diagnostic criteria
•Examples:
Collagenous Colitis (low power) Collagenous Colitis (medium power) Collagenous Colitis (high power) Collagenous Colitis (medium power-Trichrome) Collagenous Colitis (high power-Trichrome)
References

Chronic Colitis with Thickening of the Subepithelial Collagen Layer, Jessurun, J. et al, Human Pathology:18 839-848, 1987
Sleisenger MH, Fordtran JS. Gastrointestinal disease. 5th ed. Philadelphia: Saunders, 1993, pp. 1563-1565

For Most Current Information Search Medline at National Library of Medicine
This link will directly take you to the relevant new literature
Collagenous Colitis
Synopsis by: Martin Nadel, M.D. (T67000M55700)[342]
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