Compte rendu de biopsie colorectale dans les maladies inflammatoires chroniques de l'intestin (MICI) - Étape ultérieure d'une unification européenne

Recently a working party of the British Society of Gastroenterology has developed guidelines for the biopsy diagnosis of chronic inflammatory bowel disease (IBD). The guidelines provide a useful starting point for the evaluation of patients with suspected IBD, but certain amendments could lead to a better standardized approach of an IBD patient. The importance of adequate sampling for optimal diagnosis should be emphasized more strongly. This is the case because macroscopic and microscopic distribution of the inflammatory changes are very important features to distinguish ulcerative colitis (UC) from Crohn's disease (CD). The distribution pattern could also be included as a separate parameter in the microscopic assessment form. As far as the nomenclature is concerned, it is suggested to make a distinction between colitis unclassified and indeterminate colitis and to use the latter term exclusively in the differential between UC and CD. The terms fulminant colitis, microscopic colitis, pseudomembranous colitis should be incorporated as histopathological diagnostic terms and a well circumscribed histological definition of these terms should be applied. Finally, the conclusion of the pathology report should save some lines for a note, in which clinical interpretation, additional questions, desiderata and so forth concerning the histopathological diagnosis can be stated.