Rubio CA,Orrego A,Höög A,Porwitz A,Petersson F,Elmberger G,Glaessgen A,Eriksson E,Kanter L,Jaremko G,Egevad L,Laforga J,Liljefors M,Löfdahl B,Norman P,Larsson O,Wanat R,Wejde J,Zickert P,Björk J,Caini S,Palli D,Nesi G
Abstract
The thickness of eosinophilic band in collagenous colitis (CC) was assessed by 3 methods: histologic estimates (22 observers), conventional measurements using a calibrated micrometric scale (1 observer), and semiautomatic micrometric measurements (1 observer). By the histologic estimate technique, 7.4% of the results failed to diagnose CC; by calibrated micrometry, the failure was 6% and by semiautomatic micrometry, 6%. The main difficulty in measuring the thickness of the CC band is that the deeper border of the band appears fuzzy and hairy-irregular. CC should be defined not exclusively on the basis of the thickness of the collagen table, but as a microscopic constellation characterized by a distorted superficial cell arrangement, with areas of epithelial denudation and inflammatory cells in the superficial epithelium and the lamina propria. In agreement with Lazenby's statement: "Focusing solely on the collagen band can result in both over- and underdiagnosis"
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