Skip to main content
SpringerLink
Log in

Collagenous colitis: Histologic, morphometric, immunohistochemical and ultrastructural studies. Report of 21 cases

  • Published:
Virchows Archiv A Aims and scope Submit manuscript

Summary

We examined 129 colonic biopsies from 21 patients with collagenous colitis, most of whom presented with diarrhoea. Morphometric measurements gave a mean thickness of the subepithelial collagen deposit of 19.5 µ ± 5.1. The trapped fusiform and/or stellate cells within the deposits were identified immunohistochemically as myoid cells, being positive with antibody against smooth muscle cell alpha-actin. Ultrastructurally, these cells have all the characteristic features of myofibroblasts. Similar cells are also present along the crypts, where they were formerly referred to as pericryptal fibroblasts. Although there is still much debate as to the pathogenesis of this condition, we would like to suggest that collagenous colitis is a disease of pericryptal myofibroblasts. During their migration and maturation into the subepithelial region they may synthesize an excess of collagen, under some yet unknown or undefined stimulus/stimuli.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Archimandritis A, Tzivras M, Delladetsima A, Tryphonos M (1987) Collagenous colitis in Greece. Correspondence. Gut 28:230

    Google Scholar 

  • Bamford MJ, Matz LR, Armstrong JA, Harris ARC (1982) Collagenous colitis: a case report and review of the literature. Pathology 14:481–484

    Google Scholar 

  • Birembaut P, Adnet JJ, Feydy P, Bogomoletz WV (1982) Colite collagène: approche immunomorphologique de la lésion. Lettre à la rédaction. Gastroentérol Clin Biol 10:833

    Google Scholar 

  • Bogomoletz WV (1983) Collagenous colitis: a clinicopathological review. Surv Dig Dis 1:19–25

    Google Scholar 

  • Bogomoletz WV, Adnet JJ, Birembaut P, Feydy P, Dupont P (1980) Collagenous colitis: an unrecognised entity. Gut 21:164–168

    Google Scholar 

  • Breen EG, Farren C, Connolly CE, McCarthy CF (1987) Collagenous colitis and coeliac disease. Correspondence. Gut 28:364

    Google Scholar 

  • Chandratre S, Bramble MG, Cooke WM, Jones RA (1987) Simultaneous occurrence of collagenous colitis and Crohn's disease. Digestion 36:55–60

    Google Scholar 

  • Colina F, Munoz-Yagüe MT, Solis-Herruzo JA, Vazquez G, Perez-Barrios A (1982) Collagenous colitis: the clinical and morphological features. Postgrad Med J 58:390–395

    Google Scholar 

  • Debongnie JC, De Galocsy C, Caholessur MO, Haot J (1984) Collagenous colitis: a transient condition? Report of two cases. Dis Col Rect 27:672–676

    Google Scholar 

  • Eaves ER, Wallis PL, McIntyre RLE, Korman MG (1983) Collagenous colitis: a recently recognised reversible clinicopathological entity. Aust NZ J Med 13:630–632

    Google Scholar 

  • Elliot PR, Lennard-Jones JE, Bartram CI, Swarbrick ET, Williams CB, Dawson AM, Thomas BM, Morson BC (1982) Colonoscopic diagnosis of minimal change colitis in patients with a normal sigmoidoscopy and normal air-contrast barium enema. Lancet 1:650–651

    Google Scholar 

  • Farah DA, Mills PR, Lee FD, McLay A, Russel RI (1985) Collagenous colitis: possible response to sulfasalazine and local steroid therapy. Gastroenterology 88:792–797

    Google Scholar 

  • Fausa O, Foerster A, Hovig T (1985) Collagenous colitis. A clinical, histological, and ultrastructural study. Scand J Gastroenterol 20 (Suppl 107):8–23

    Google Scholar 

  • Flejou JF, Grimaud JA, Molas G, Baviera E, Potet F (1984) Collagenous colitis. Ultrastructural study and collagen immunotyping of four cases. Arch Pathol Lab Med 108:977–982

    Google Scholar 

  • Gabbiani G, Hirschel BJ, Ryan BG, Statkov PR, Majno G (1972) Granulation tissue as a contractile organ. A study of structure and function. J Exp Med 135:719–734

    Google Scholar 

  • Galian A, Le Charpentier Y, Goldfain D, Chauveinc L (1982) La colite collagène. Apropos d'un nouveau cas avec étude ultrastructurale. Gastroentérol Clin Biol 6:365–370

    Google Scholar 

  • Gardiner GW, Goldberg R, Currie D, Murray D (1984) Colonic carcinoma associated with an abnormal collagen table. Collagenous colitis. Cancer 54:2973–2977

    Google Scholar 

  • Giardiello FM, Bayless TM, Jessurun J, Hamilton ST, Yardley JH (1987) Collagenous colitis: physiologic and histopathologic studies in seven patients. Ann Intern Med 106:46–49

    Google Scholar 

  • Grouls V, Vogel J, Sorger M (1982) Collagenous colitis. Endoscopy 14:31–33

    Google Scholar 

  • Guarda LA, Nelson RS, Stroehlein JR, Korinek JK, Raymond AK (1983) Collagenous colitis. Am J Clin Pathol 80:503–507

    Google Scholar 

  • Güller R, Anabitarte M (1981) Die “Kollagenkolitis”. Ein neues Krankheitsbild oder bloβe histologische Abnormität? Schweiz Med Wochenschr 111:1076–1079

    Google Scholar 

  • Hamilton I, Sanders S, Hopwood D, Bouchier IAD (1986) Collagenous colitis associated with small intestinal villous atrophy. Gut 27:1394–1398

    Google Scholar 

  • Höchter W, Seib HJ, Elster K, Kaduk B, Ottenjann R (1982). Kollagene Kolitis. Dtsch Med Wochenschr 107:257–260

    Google Scholar 

  • Hwang WS, Kelly JK, Shaffer EA, Hershfield NB (1986) Collagenous colitis: a disease of pericryptal fibroblast sheath? J Pathol 149:33–40

    Google Scholar 

  • Jessurun J, Yardley JH, Giardiello FM, Hamilton SR, Bayless TM (1987) Chronic colitis with thickening of the subepithelial collagen layer (collagenous colitis): Histopathologic findings in 15 patients. Hum Pathol 18:839–848

    Google Scholar 

  • Kaye GI, Lane N, Pascal RR (1968) Colonic pericryptal fibroblast sheath: replication, migration, and cytodifferentiation of a mesenchymal cell system in adult tissue. II. Fine structural aspects of normal rabbit and human colon. Gastroenterology 54:852–865

    Google Scholar 

  • Kingham JGC, Levison DA, Ball JA, Dawson AM (1982) Microscopic colitis - a cause of chronic watery diarrhoea. Br Med J 285:1601–1604

    Google Scholar 

  • Kingham JGC, Levison DA, Morson BC, Dawson AM (1986) Collagenous colitis. Gut 27:570–577

    Google Scholar 

  • Levine E, Giardiello F, Lazenby A, Hamilton S, Yardley J, Bayless T (1987) Microscopic colitis and collagenous colitis: clinicopathologic variants of the same condition? Gastroenterology 92:1504

    Google Scholar 

  • Lindström CG (1976) “Collagenous colitis” with watery diarrhoea- A new entity? Path europ 11:87–89

    Google Scholar 

  • Loo FD, Wood CM, Soergel KH, Komorowski RA, Cheung H, Gay S, Gay RE (1985) Abnormal collagen deposition and ion transport in collagenous colitis. Gastroenterology 88:1481

    Google Scholar 

  • Maroy B, Moullot P (1984) Colite collagène. Association à une arthropathie inflammatoire ehronique. Lettre à l'éditeur. Presse méd 13:1516

    Google Scholar 

  • Maroy B, Moullot P, Brulé M, Lancret C, Faure JY (1985) Colite collagène coexistant avec un polyadénome. Effet favorable de la mépacrine. Lettre à la rédaction. Gastroentérol Clin Biol 9:453–454

    Google Scholar 

  • Mason CH, Jewell DP (1985) Collagenous colitis: a report of five cases. Gut 26:A1152

    Google Scholar 

  • Pariente EA, Chaumette MT, Maître F, Delchier JC, Soulé JC, Bader JP (1985) Colite collagéne, déficit en IgA, maladie de Basedow et gastrite atrophique. Gastroentérol Clin Biol 9:738–741

    Google Scholar 

  • Pariente EA, Maître F (1986) Collagenous colitis. Letter to the Editor. Dig Dis Sci 31:222

    Google Scholar 

  • Pieterse AS, Hecker R, Rowland R (1982) Collagenous colitis: a distinctive and potentially reversible disorder. J Clin Pathol 35:338–340

    Google Scholar 

  • Rams H, Rogers AI, Ghandur-Mnaymneh L (1987) Collagenous colitis. Ann Intern Med 106:108–113

    Google Scholar 

  • Rask-Madsen J, Grove O, Hansen MGJ, Bukhave K, Henrik-Nielsen R (1983) Colonic transport of water and electrolytes in a patient with secretory diarrhea due to collagenous colitis. Dig Dis Sci 28:1141–1146

    Google Scholar 

  • Richman PI, Tilly R, Jass JR, Bodmer WF (1987) Colonic pericrypt sheath cells: characterisation of cell type with new monoclonal antibody. J Clin Pathol 40:593–600

    Google Scholar 

  • Serin M, Monges G, Pellegrin M, Monges A (1986) La colite collagéne. Ann Gastroentérol Hépatol 22:83–86

    Google Scholar 

  • Skalli O, Ropraz P, Trzeciak A, Benzonana G, Gillessen D, Gabbiani G (1986) A monoclonal antibody against alpha-smooth muscle actin: a new probe for smooth muscle differentiation. J Cell Biol 103:2787–2796

    Google Scholar 

  • Stubbe-Teglbjaerg P, Hess-Thaysen E (1982) Collagenous colitis: an ultrastructural study of a case. Gastroenterology 82:561–563

    Google Scholar 

  • Wang KK, Perrault J, Carpenter HA, Schroeder KW, Tremaine WJ (1987) Collagenous colitis: a clinicopathologic correlation. Mayo Clin Proc 62:665–671

    Google Scholar 

  • Weibel ER, Kistler AS, Scherle WF (1966) Practical stereological methods for morphometric cytology. J Cell Biol 30:22–38

    Google Scholar 

  • Whitehead R (1979) Mucosal biopsy of the gastrointestinal tract. Major Problems in Pathology, Vol. 3, 2nd edition. WB Saunders Co, Philadelphia London, Toronto

    Google Scholar 

  • Williams GT, Rhodes J (1987) Collagenous colitis: disease or diversion? Correspondence. Br Med J 294:855–856

    Google Scholar 

  • Yeshaya C, Novis B, Bernheim J, Leichtmann G, Samara M, Griffel B (1984) Collagenous colitis. Report of a case. Dis Colon Rectum 27:111–113

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pathology, Centre Médical Universitaire, Geneva University, CH-1211, Geneva-4, Switzerland

    Sven Widgren, Rachid Jlidi & Jeremiah N. Cox

Authors
  1. Sven Widgren
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rachid Jlidi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jeremiah N. Cox
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Widgren, S., Jlidi, R. & Cox, J.N. Collagenous colitis: Histologic, morphometric, immunohistochemical and ultrastructural studies. Report of 21 cases. Vichows Archiv A Pathol Anat 413, 287–296 (1988). https://doi.org/10.1007/BF00783020

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00783020

Key words

Search

Navigation