This specimen is a
complete cross section of colon and the action is taking place on the mucosal
surface and the mucus seen in the lumen (the detached junk). In this
case, the history of the patient is key to making the diagnosis. What
history do we mean?
As you may know, this
condition is caused by antibiotic usage. The causative organism is a clostridial
organism that can sporulate, and return after the antibiotic has disappeared.
The bug is actually on the surface of the bowel, and elicits a marked acute
inflammatory response. Here you will see an acute inflammatory exudate in
some of the crypts and on the surface of the mucosa. You won't be able to
see the organisms in all likelihood. The insert shows
the PMNs in the mucus.
