Abstract

Background: Chronic colitis, regardless of type, is defined histologically by chronic
inflammation, mainly plasmacytosis, in the lamina propria. Specific diagnosis of chronic
colitides in biopsies can be challenging for practicing pathologists. The present research was
undertaken to study complete clinico-pathology of chronic colitis, pathological pattern and
spectrum of colitis, also study correlation of colonoscopy and histopathology of these
lesions.Method:This study was a retrospective and prospective analysis of 187 cases
ofhistopathologicallyproven colitis on colonic biopsies over a period of 5 years from June 2015
to May 2020. Results:Majority of specimen were rectal biopsies (57.22%) followed by mapping
biopsies (34.22%). Of 85 cases where both colonoscopy and histopathology diagnosis was
available, 61 (71.76%) colonoscopy diagnosis were consistent with histopathology. Among 187
cases, 107 were inflammatory bowel disease (57.22%), they were further sub classified as
ulcerative colitis (UC) (96.26%), Crohn’s (0.93%) and indeterminate colitis (2.8%). Cases of
UC had features of basal plasmacytosis (97.19%), crypt distortion (93.45%), crypt loss
(70.09%) and goblet cell depletion.48cases diagnosed as non-specific colitis. Infectious colitis
comprised 8.56% of total colitis cases. It included tuberculosis 4 (2.14%), CMV colitis
2(1.07%) and 5.35% cases of acute self-limiting colitis. 5(2.67%) cases were diagnosed as
lymphocytic colitis and 2 cases showed focal active colitis. Also, found single case of
eosinophilic colitis and radiation proctitis each.Conclusion:Good clinico-pathological
correlation helps to reduce number of cases diagnosed as non-specific colitis. To improve the
detection rate of microscopic colitis, it is important to take multiple biopsies from normal
looking colon on colonoscopy.