TableĀ 12

Histological mimics of IBD

CategoryDiseaseCommentClinical correlation
Close mimicsDiverticular colitisUsually localised to sigmoid
Often older patients
History/endoscopy required for diagnosis
Diversion proctocolitisMay resemble ulcerative colitisHistory required for diagnosis
Other mimicsHIV-related colitisMay resemble Crohn's disease (patchy colitis) but crypt changes uncommonHistory required for diagnosis
Mucosa over a mass lesionRare cause of IBD-like changes
Localised to one area
History/imaging required for diagnosis
May share some featuresIschaemiaMay show crypt changesOften localised, eg, splenic flexure
Radiation colitisMay show crypt changesHistory required for diagnosis
Microscopic colitisPlasmacytosis, sometimes basal; no crypt changesEndoscopy normal
Graft-versus-host diseaseCrypt distortion and atrophy
Apoptoses in acute Graft versus host disease (GVHD)
Chronic GVHD resembles quiescent IBD
History needed for diagnosis
Specific infectionsLymphogranuloma venereum/syphilisMay resemble Crohn's disease
Left-sided more than right
HIV/risk factors
TuberculosisGranulomasRisk factors
  • IBD, inflammatory bowel disease.