Question

Give an example of pseudomembranous inflammation and describe its pathological features?

Answer 1

Pseudomembaranous Colitis

This is an inflammatory conditionin which it cause the swelling of large intestine due to an overgrowth of Clostridioides difficile (C difficile) bacteria.

Most of the people experience diarrhoea after antibiotics ingestion and this is found to be as a major cause of it.

Pathological features

Gross features include

-Pseudomembrane :- which looks pale yellow or white even with raised lesions of the mucosa or Yellow-white mucosal plaques can be seen.

-The lesions can be of less than 10 mm if its early onset.

-The interlesional mucosa often appears normal in gross structure.

Microscopic structure

-Appearance of necrosis of the epithelium usually refered as Heaped or as "volanco lesions" - this is what is seen endoscopically .

-Mucopurulent exudate erupts out of crypts to form a mushroom-like structure with debris and neutrophils that adheres to surface.

-Superficial crypts show patchy necrosis and dilation

-Later on as progress , entire crypt becomes necrotic and disease resembles ischemic colitis.

-Capillary fibrin thrombi can also be seen microscopically.

-Pseudomembranes associated with collagenous colitis are reported rarely.

-Rarely can have (benign) signet ring cell-like cells.