Canavese G, Bassotti G, Astegiano M, Castellano I, Cassoni P, Sapino A, Villanacci V. Inflammatory bowel disease: A proposal to facilitate the achievement of an unequivocal diagnosis. World J Gastroenterol 2013; 19(3): 426-428 [PMID: 23372370 DOI: 10.3748/wjg.v19.i3.426]
Corresponding Author of This Article
Anna Sapino, Professor, III Service of Pathology, Department of Laboratory Diagnosis, Azienda Ospedaliera Città della Salute e della Scienza di Torino, Department of Medical Sciences University of Torino, 10100 Torino, Italy. gcanavese@molinette.piemonte.it
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Canavese G, Bassotti G, Astegiano M, Castellano I, Cassoni P, Sapino A, Villanacci V. Inflammatory bowel disease: A proposal to facilitate the achievement of an unequivocal diagnosis. World J Gastroenterol 2013; 19(3): 426-428 [PMID: 23372370 DOI: 10.3748/wjg.v19.i3.426]
World J Gastroenterol. Jan 21, 2013; 19(3): 426-428 Published online Jan 21, 2013. doi: 10.3748/wjg.v19.i3.426
Inflammatory bowel disease: A proposal to facilitate the achievement of an unequivocal diagnosis
Gabriella Canavese, Gabrio Bassotti, Marco Astegiano, Isabella Castellano, Paola Cassoni, Anna Sapino, Vincenzo Villanacci
Gabriella Canavese, Isabella Castellano, Paola Cassoni, Anna Sapino, III Service of Pathology, Department of Laboratory Diagnosis, Azienda Ospedaliera Città della Salute e della Scienza di Torino, Department of Medical Sciences, University of Torino, 10100 Torino, Italy
Gabrio Bassotti, Gastroenterology and Hepatology Section, Department of Clinical and Experimental Medicine, University of Perugia, 06100 Perugia, Italy
Marco Astegiano, Gastroenterology and Hepatology Section Azienda Ospedaliera Città della Salute e della Scienza di Torino, 10100 Torino, Italy
Vincenzo Villanacci, Department of Pathology, Spedali Civili of Brescia, 25100 Brescia, Italy
Author contributions: Canavese G conceived the proposal and wrote the manuscript; Bassotti G and Astegiano M collaborated in the proposal design; Castellano I and Cassoni P critically revised the manuscript; Sapino A collaborated to the proposal design and drafting of the article; and Villanacci V conceived the proposal.
Supported by Fondazione Malattie Infiammatorie Intestinali (IBD) Onlus - Torino; Compagnia San Paolo, Torino
Correspondence to: Anna Sapino, Professor, III Service of Pathology, Department of Laboratory Diagnosis, Azienda Ospedaliera Città della Salute e della Scienza di Torino, Department of Medical Sciences University of Torino, 10100 Torino, Italy. gcanavese@molinette.piemonte.it
Telephone: +39-11-6334273 Fax: +39-11-6635267
Received: September 25, 2012 Revised: December 18, 2012 Accepted: December 22, 2012 Published online: January 21, 2013 Processing time: 118 Days and 15.3 Hours
Abstract
Following the international guidelines criteria an adequate “diagnostic conclusion” of inflammatory bowel disease (IBD) can be achieved only if clinical, endoscopic and laboratory findings, together with sample technical adequacy and unequivocal histomorphological signs of the disease are available. Thus, a conclusive diagnosis requires a complex combination of clinical, endoscopic and histological data. A considerable number of endoscopic biopsies obtained from IBD patients do not meet the above-mentioned requirements. The aim of the present proposal is to introduce a binary system of evaluation in the “diagnostic conclusion” of the histopathological report that will help to simplify the clinical decisions and consequent patient management. In patients with no history of disease, the pathologist should classify the biopsies in “Diagnostic”, when the criteria established by the international guidelines are satisfied and “not diagnostic” when one or more of the above-mentioned criteria are not met. The term “not diagnostic” should replace “highly suggestive” and “probable”. This new terminology could avoid ambiguous expressions that encourage the clinician to classify the patient as affected by IBD without fulfilling all of the requirements for an accurate diagnostic approach.
