Rectal biopsy shows goblet cell depletion (216/1700)

A young woman complains of diarrhea, abdominal cramps and mouth ulcers. AXR shows
distended transverse colon with globet cell depletion on rectal biopsy. What is the most
probable dx?

a. CD
b. UC
c. Bowel Ca
d. Bowel obstruction
e. IBS





























ANSWER: B


They have give you a clinical presentation with some features to resembling crohns to confuse you, but included information about a biopsy which is definitive for UC.

Histologic Features

CROHNS

Transmural distribution with skip lesions

Focal inflammation ± noncaseating granulomas,

Deep fissuring + aphthous ulcerations, strictures

Glands intact (e.g. goblet cells)

ULCERATIVE COLITIS

Mucosal distribution, continuous disease (no skip lesions)

Granulomas absent,

Crypt abscess

Gland destruction(e.g. goblet cells)

 


N.b rectal bleeding a feature of UC but initial presentation is usually with non bloody diarheaa
UC can occur anywhere in the lower bowel, from rectum to entire colon...CD: most common location is ileum and ascending colon.