Roger Feakins1, Joana Torres2, Paula Borralho-Nunes3, Johan Burisch4, Tiago Cúrdia Gonçalves5,6,7, Lissy De Ridder8, Ann Driessen9, Triana Lobatón10, Luis Menchén11,12,13, Aart Mookhoek14, Nurulamin Noor15, Magali Svrcek16, Vincenzo Villanacci17, Nina Zidar18, Monika Tripathi19. 1. Department of Cellular Pathology, Royal Free Hospital, London, and University College London, UK. 2. Department of Gastroenterology, Hospital Beatriz Ângelo, Loures, Portugal. 3. Department of Pathology, Hospital Cuf Descobertas, Lisboa and Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal. 4. Gastrounit, Medical Division, Hvidovre Hospital, University of Copenhagen, Denmark. 5. Department of Gastroenterology, Hospital da Senhora da Oliveira, Guimarães, Portugal. 6. School of Medicine, University of Minho, Braga/Guimarães, Portugal. 7. ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal. 8. Department of Paediatric Gastroenterology, Erasmus MC Sophia Children's Hospital, University Medical Center Rotterdam, The Netherlands. 9. Department of Pathology, University Hospital Antwerp, University Antwerp, Edegem, Belgium. 10. Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium. 11. Department of Digestive System Medicine, Hospital General Universitario-Insitituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain. 12. Department of Medicine, Universidad Complutense, Madrid, Spain. 13. Centro de Investigación Biomédica En Red de Enfermedades Hepáticas y Digestivas [CIBEREHD], Madrid, Spain. 14. Department of Pathology, Amsterdam UMC, Amsterdam, The Netherlands. 15. Department of Gastroenterology, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust, Cambridge, UK. 16. Department of Pathology, Sorbonne Université, AP-HP, Saint-Antoine Hospital, Paris, France. 17. Department of Histopathology, Spedali Civili and University of Brescia, Brescia, Italy. 18. Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia. 19. Department of Histopathology, Cambridge Biomedical Campus, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Abstract
INTRODUCTION: Many diseases can imitate inflammatory bowel disease [IBD] clinically and pathologically. This review outlines the differential diagnosis of IBD and discusses morphological pointers and ancillary techniques that assist with the distinction between IBD and its mimics. METHODS: European Crohn's and Colitis Organisation [ECCO] Topical Reviews are the result of an expert consensus. For this review, ECCO announced an open call to its members and formed three working groups [WGs] to study clinical aspects, pathological considerations, and the value of ancillary techniques. All WGs performed a systematic literature search. RESULTS: Each WG produced a draft text and drew up provisional Current Practice Position [CPP] statements that highlighted the most important conclusions. Discussions and a preliminary voting round took place, with subsequent revision of CPP statements and text and a further meeting to agree on final statements. CONCLUSIONS: Clinicians and pathologists encounter a wide variety of mimics of IBD, including infection, drug-induced disease, vascular disorders, diverticular disease, diversion proctocolitis, radiation damage, and immune disorders. Reliable distinction requires a multidisciplinary approach.
INTRODUCTION: Many diseases can imitate inflammatory bowel disease [IBD] clinically and pathologically. This review outlines the differential diagnosis of IBD and discusses morphological pointers and ancillary techniques that assist with the distinction between IBD and its mimics. METHODS: European Crohn's and Colitis Organisation [ECCO] Topical Reviews are the result of an expert consensus. For this review, ECCO announced an open call to its members and formed three working groups [WGs] to study clinical aspects, pathological considerations, and the value of ancillary techniques. All WGs performed a systematic literature search. RESULTS: Each WG produced a draft text and drew up provisional Current Practice Position [CPP] statements that highlighted the most important conclusions. Discussions and a preliminary voting round took place, with subsequent revision of CPP statements and text and a further meeting to agree on final statements. CONCLUSIONS: Clinicians and pathologists encounter a wide variety of mimics of IBD, including infection, drug-induced disease, vascular disorders, diverticular disease, diversion proctocolitis, radiation damage, and immune disorders. Reliable distinction requires a multidisciplinary approach.