Correlation between histological findings and endoscopic findings in patients with ulcerative colitis: Basal plasmacytosis is an important finding suggesting active inflammation

Abstract

Aims: In clinical practice, patients of ulcerative colitis showing divergence between the histological findings and endoscopic findings are often encountered. Therefore, we compared histological findings with endoscopic findings, indicating the severity of the inflammation of ulcerative colitis. Methods and Results: The study group comprised 191 patients (527 biopsy specimens) with ulcerative colitis who underwent lower gastrointestinal endoscopy with biopsy in our hospital from July 2015 to June 2016. Endoscopic findings of the mucosa at the biopsy site were classified into seven levels according to the severity of inflammation: noninflamed mucosa, red signs, loss of visible vascular patterns, granular mucosa, friable mucosa, spontaneous bleeding, and erosions/ulcers (E/U). All biopsy samples were examined for the presence or absence of five histological findings (basal plasmacytosis [BP], neutrophil infiltration, cryptitis, crypt abscess [CAb], and E/U), and the results were contrasted with endoscopic findings. The 191 patients comprised 123 (64.4%) males and 68 (35.6%) females, with a median age of 47 years (range, 8–82). Among the 527 specimens, the detection rates of BP, CAb, and E/U in mucosa with endoscopic E/U were 58.5, 27.4, and 18.3%. The detection rate of BP in mucosa with red signs was 22.4%; in mucosa, with loss of visible vascular patterns, it was 16.9%; in granular mucosa, it was 35.7%, and in mucosa with E/U, it was 58.5%. BP was frequently seen in severely inflamed mucosa associated with E/U on endoscopic examination. Conclusion: BP was considered an important finding, suggesting the presence of active and severe inflammation.