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The Apoptotic Crypt Abscess: An Underappreciated Histologic Finding in Gastrointestinal Pathology.

Am J Clin Pathol; 148(6): 538-544, 2017 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-29140405

OBJECTIVES:

To differentiate apoptotic crypt abscesses (ACAs) from neutrophilic crypt abscesses (NCAs).

METHODS:

Cases with crypt abscesses were classified as containing ACAs, NCAs, or mixed crypt abscesses (MCAs) by H&E staining. Sections were stained with cleaved caspase 3 and myeloperoxidase and recategorized.

RESULTS:

Fifty-nine cases were reviewed: inflammatory bowel disease (IBD; n = 33), acute cellular rejection (n = 5), graft vs host disease (GVHD; n = 14), cytomegalovirus (n = 5), and drug reaction (n = 2). Concordance was seen in 59%, with most reclassifications resulting from a change of ACAs to MCAs. When cases were classified as having NCA vs those with apoptosis (ACA and MCA), there was 85% agreement (P < .01). NCAs were present in IBD (96%) and not in GVHD or drug injury. Crypt abscesses with apoptosis were seen in 18% of IBD and 96% of non-IBD cases.

CONCLUSIONS:

ACAs and MCAs can be distinguished from NCAs and may be a diagnostically useful finding.