What is a hallmark histologic feature of ulcerative colitis?

What is a hallmark histologic feature of ulcerative colitis?

• A. Continuous mucosal inflammation with crypt abscesses and loss of haustra.
• B. Transmural inflammation with skip lesions.
• C. Granulomas with transmural inflammation.
• D. Fistula formation with mucous plaques.

Answer: (A)

Ulcerative colitis is best recognized histologically by continuous mucosal inflammation that starts in the rectum and extends proximally, with neutrophils forming crypt abscesses within the glands and with loss of normal crypt architecture and mucosal structure. This pattern—inflammation confined to the mucosa and submucosa, lacking skip lesions, and featuring crypt abscesses—is characteristic of UC and underlies the appearance of a smooth, “lead-pipe” colon on chronic inflammatory change. In contrast, Crohn disease would show transmural inflammation with skip areas, and granulomas or fistulas may be present, which are not typical of UC. Therefore, continuous mucosal inflammation with crypt abscesses and loss of haustra best fits ulcerative colitis.

Ulcerative colitis is best recognized histologically by continuous mucosal inflammation that starts in the rectum and extends proximally, with neutrophils forming crypt abscesses within the glands and with loss of normal crypt architecture and mucosal structure. This pattern—inflammation confined to the mucosa and submucosa, lacking skip lesions, and featuring crypt abscesses—is characteristic of UC and underlies the appearance of a smooth, “lead-pipe” colon on chronic inflammatory change. In contrast, Crohn disease would show transmural inflammation with skip areas, and granulomas or fistulas may be present, which are not typical of UC. Therefore, continuous mucosal inflammation with crypt abscesses and loss of haustra best fits ulcerative colitis.