What are the histological features of ulcerative colitis?

Ulcerative colitis is characterized by specific histological features that reflect its pathophysiology. The presence of superficial inflammation with crypt abscesses is a hallmark of this condition. In ulcerative colitis, the inflammation primarily affects the mucosal and submucosal layers of the colon.

The inflammatory process leads to the destruction of crypts in the intestinal epithelium, resulting in the formation of crypt abscesses. This occurs due to the infiltration of neutrophils into the colonic crypts, causing localized collections of pus. The inflammation tends to be diffuse and continuous, affecting large portions of the colon, often with a distinctive pattern of mucosal ulceration.

In contrast to conditions like Crohn's disease, where transmural inflammation and granulomas are seen, ulcerative colitis does not typically present with deep transmural inflammation or granulomas. The reliance on the mucosal surface for inflammation and the unique presence of crypt abscesses helps distinguish ulcerative colitis from other inflammatory bowel diseases, underscoring the importance of recognizing these specific features in diagnosis and management.