Slide
1
Gross: As the crypt abscesses of ulcerative colitis increase in size, they undermine the adjacent mucosa, which sloughs to form numerous, closely placed, shallow ulcers covered by fibrinopurulent exudate (U). Almost total ulceration occurs in severe cases, in which the surface is intensely hemorrhagic. Healing of extensively ulcerated areas is initiated by granulation tissue. Residual inflamed mucosa and exuberant granulation tissue often form nodules elevated above the surrounding mucosa that are called "inflammatory pseudopolyps" (P). A histologic section taken across the pseudopolyps and ulcers in the plane of the black bar would have the appearance shown in Slide 2.
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