Endoscopy 2008; 40(7): 606-608
DOI: 10.1055/s-2008-1077376
Case report

© Georg Thieme Verlag KG Stuttgart · New York

Collagenous colitis: a case series with confocal laser microscopy and histology correlation

A.  Zambelli1 , V.  Villanacci2 , E.  Buscarini1 , G.  Bassotti3 , L.  Albarello4
  • 1Gastroenterology and Endoscopy Unit, Maggiore Hospital, Crema, Italy
  • 2Second Pathology Department, Spedali Civili, Brescia, Italy
  • 3Gastroenterology and Hepatology Section, Department of Clinical and Experimental Medicine, University of Perugia, Italy
  • 4Department of Pathology, IRCCS San Raffaele, Milan, Italy
Further Information

Publication History

submitted 21 January 2008

accepted after revision 20 March 2008

Publication Date:
07 July 2008 (online)

Confocal laser endomicroscopy (CLE) was carried out in seven patients with chronic watery diarrhea (three men; age range 68 – 84 years) to find the correspondence between CLE and histological findings in collagenous colitis. On the basis of the CLE images, two to five biopsies were performed in various segments of the colon. The endoscopic and histological diagnoses of collagenous colitis were made blindly. The quality of the CLE images was quantified from 0 (the endoscopist could not visualize the corresponding histologic equivalent) to 3 (the endoscopist could identify ≥ 80 % of the corresponding histologic equivalent). Four out of seven patients had histological findings of collagenous colitis. Correspondence between histology and CLE images yielded the following scores: 3 for epithelial architecture, 3 for goblet cells, 3 for vessels, and 2 for inflammatory infiltrate. In collagenous colitis patients, CLE identified a well-defined “shell” around the crypts, corresponding to the increase in the thickness of the subepithelial collagenous plate evidenced by histology. CLE appears to be a promising means of identifying typical collagenous colitis features.


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A. Zambelli, MD

Gastroenterology and Endoscopy Unit
Maggiore Hospital

Largo Dossena 2
26013 Crema

Fax: +39-373-280654

Email: a.zambelli@hcrema.it