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Lymphoid follicular proctitis
Authors:Dr. J. F. Fléjou MD  F. Potet MD  W. V. Bogomoletz FRCPath  MD  C. Rigaud MD  A. Fenzy MD  Y. LE Quintrec MD  D. Goldfain MD  N. Brousse MD
Affiliation:(1) Pathology Departments of HÔpital Beaujon, Clichy, Institut Jean Godinot, Reims;(2) INSERM U239 Faculté X, Bichat, Paris, France;(3) Service Central d'Anatomie Pathologique, HÔpital Beaujon, 100, Boulevard Général Leclerc, 92118 Clichy, France
Abstract:A heterogeneous group is formed by patients presenting with clinical features suggestive of inflammatory bowel disease limited to the rectum and whose rectal biopsies show lymphoid follicular hyperplasia of the mucosa. All these cases are traditionally considered as one variant of chronic ulcerative colitis, so-called ulcerative proctitis. Twenty such cases were critically assessed on clinical, endoscopic, and histologic grounds, as well as on response to treatment and follow-up data. While 11 patients showed clinicopathologic features consistent with typical chronic ulcerative colitis, the other nine patients appeared to form a different group, for which the term ldquolymphoid follicular proctitisrdquo seemed justified. Lymphoid follicular proctitis was, overall, characterized by rectal bleeding, a congested and granular mucosa without ulceration, abnormal and coalescing hyperplastic lymphoid follicle s without acute inflammation, and failure to respond to local steroid therapy. The nature of lymphoid follicular proctitis is uncertain at present but seems unrelated to chronic ulcerative colitis.
Keywords:lymphoid follicular proctitis  lymphoid hyperplasia  ulcerative proctitis  rectal bleeding
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