European consensus on the histopathology of inflammatory bowel disease

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The histologic examination of endoscopic biopsies or resection specimens remains a key step in the work-up of affected inflammatory bowel disease (IBD) patients and can be used for diagnosis and differential diagnosis, particularly in the differentiation of UC from CD and other non-IBD related colitides. The introduction of new treatment strategies in inflammatory bowel disease (IBD) interfering with the patients' immune system may result in mucosal healing, making the pathologists aware of the impact of treatment upon diagnostic features. The European Crohn's and Colitis Organisation (ECCO) and the European Society of Pathology (ESP) jointly elaborated a consensus to establish standards for histopathology diagnosis in IBD. The consensus endeavors to address: (i) procedures required for a proper diagnosis, (ii) features which can be used for the analysis of endoscopic biopsies, (iii) features which can be used for the analysis of surgical samples, (iv) criteria for diagnosis and differential diagnosis, and (v) special situations including those inherent to therapy. Questions that were addressed include: how many features should be present for a firm diagnosis? What is the role of histology in patient management, including search for dysplasia? Which features if any, can be used for assessment of disease activity? The statements and general recommendations of this consensus are based on the highest level of evidence available, but significant gaps remain in certain areas. 

Keywords: histopathology; chronic ulcerative colitis; low-grade dysplasia; pouch-anal anastomosis; self-limited colitis; difficile-associated diarrhoea; focally enhanced gastritis; Crohn's disease; collagenous colitis; microscopic colitis; lymphocytic colitis

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Source File

Publishing organization(s):

ESP European Society of Pathology

Scientific area:

IBD, Histopathology

This item can be cited as: Journal of Crohn's and Colitis (2013) 7, 827-851; PMID 23870728


  • Format
    • Standards and Guidelines
  • Language
    • English
  • UEG Member Society
    • European Crohn’s and Colitis Organisation (ECCO)
  • UEG Week Pathway
    • Histopathology
    • IBD
  • Year
    • 2013