Cat Scratch Colon in a Patient With Lymphocytic Colitis

Abstract

A 44-year-old woman came to our gastroenterology clinic with a 1-week history of mild abdominal pain and loose stool. Her prior medical history was unremarkable. She had not recently taken any medication. The results of a physical examination and laboratory tests were normal. Colonoscopy showed lesions with linear mucosal tears and fresh blood on the proximal ascending colon (a). Mucosal biopsies were performed on the linear mucosal tear lesion. Histologically, the colonic mucosa showed dense lymphoplasmacytic infiltration in the lamina propria and surface epithelium (b). There was no evidence of chronic injury to crypts, including crypt distortion or branching (hematoxylin and eosin stain, ×200). Immunohistochemistry revealed colonic epithelial lymphocytosis (20–25/100 surface epithelial cells) of T cells (CD3+, ×400), particularly cytotoxic T cells (inset, CD8+, ×400) (c). In a subsequent visit to an outpatient clinic, she said her symptoms had subsided and she planned to make regular follow-up visits without specific treatment. (Informed consent was obtained from the patient to publish these images.)