Polypoid Collagenous Colitis: A Microscopic Colitis with a Macroscopic Appearance

Polypoid Collagenous Colitis: A Microscopic Colitis with a Macroscopic Appearance

David Gay, MD1, Darcy Broughel-Baer, DO2, Rachel Hudacko, MD3
1Department of Pathology, Immunology, and Laboratory Medicine, Rutgers New Jersey Medical School, Medical Science Building C-579, 185 South Orange Avenue, Newark, New Jersey 07103
2Department of Pathology, Orange Regional Medical Center, 707 East Main Street, Middletown, New York 10940
3Department of Pathology and Laboratory Medicine, Rutgers Robert Wood Johnson Medical School, MEB 212, 125 Paterson Street, New Brunswick, New Jersey 08901

Open Journal of Gastroenterology and Hepatology

Collagenous colitis is a type of microscopic colitis which was originally named based on specific histologic features and the lack of macroscopic abnormalities in the colon. However, there are reports in the literature that describe various macroscopic findings on colonoscopy in patients with histologically confirmed microscopic colitis. We report a case of collagenous colitis that was characterized by a diffusely polypoid colonic mucosa on gross examination of a right hemicolectomy specimen that was performed for a benign neoplasm in a 72 year old man. It is important for endoscopists to be aware of the various macroscopic abnormalities that may be present in this “microscopic” disease.

Keywords: Collagenous colitis (CC), microscopic colitis (MC), colon polyps, endoscopy

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How to cite this article:
David Gay,Darcy Broughel-Baer, Rachel Hudacko. Polypoid Collagenous Colitis: A Microscopic Colitis with a Macroscopic Appearance.Open Journal of Gastroenterology and Hepatology, 2020, 3:36. DOI: 10.28933/ojgh-2020-04-2805


1. Miehlke S, Verhaegh B, Tontini GE, Madisch A, Langner C, Munch A. Microscopic colitis: pathophysiology and clinical management. Lancet Gastroenterol Hepatol 2019; 4: 305-314.
2. Lazenby AJ, Yardley JH, Giardiello FM, Jessurun J, Bayless TM. Lymphocytic (“microscopic”) colitis: A comparative histopathologic study with particular reference to collagenous colitis. Hum Pathol 1989; 20(1): 18-28.
3. Loreau J, Duricova D, Gower-Rousseau C, Savoye G, Ganry O, Ben Khadra H, Sarter H, Yzet C, LeMouel JP, Kohut M, Brazier F, Chatelain D, Nguyen-Khac E, Dupas JL, Fumery M. Long-term natural history of microscopic colitis: A population-based cohort. Clin Trans Gastroenterol 2019;10(9):e00071.
4. Bohr J, Tysk C, Eriksson S, Abrahamsson H, Jarnerot G. Collagenous colitis: a retrospective study of clinical presentation and treatment in 163 patients. Gut 1996;39: 846-851.
5. Beaugerie L and Pardi DS. Review article: drug-induced microscopic colitis – proposal for a scoring system and review of the literature. Aliment Pharmacol Ther 2005;22: 277-284.
6. Pardi DS. Diagnosis and management of microscopic colitis. Am J Gastroenterol 2017;112: 78-85.
7. Lindstrom CG. Collagenous colitis with watery diarrhea. A new entity? Pathol Eur 1976;11: 87-89.
8. Smiley DN and Barkin J. Unusual endoscopic appearance of collagenous colitis. J Clin Gastroenterol 1993;17(1): 84-85.
9. Freeman HJ and Nimmo M. Carpet-like polypoid lesion in collagenous colitis with mucosal giant cells. Can J Gastroenterol 2011; 25(4): 187-188.
10. Koulaouzidis A and Saeed AA. Distinct colonoscopy findings of microscopic colitis: not so microscopic after all? World J Gastroenterol 2011;17(37): 4157-4165.
11. Kothadia JP, Manatsathit W, and Nakayuenyongsuk W. Spontaneous tear after insufflation: a unique finding of collagenous colitis. Clin Gastroenterol Hepatol 2018;16: e60.
12. Shiratori Y and Fukuda K. Collagenous colitis diagnosed by endoscopically induced mucosal tears. BMJ Case Rep 2019;12: e230570.
13. Marlicz W, Skonieczna-Zydecka K, Yung DE, Loniewski I, Koulaouzidis A. Endoscopic findings and colonic perforation in microscopic colitis: a systematic review. Dig Liver Dis 2017;49(10): 1073-1085.
14. Chang F, Deere H, and Vu C. Atypical forms of microscopic colitis: morphological features and review of the literature. Adv Anat Pathol 2005;12: 203-211.

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