The apoptotic crypt abscess an underappreciated histologic finding in gastrointestinal pathology

Geoffrey Talmon, Tristan Manasek, Ross Miller, David Muirhead, Audrey Lazenby

Research output: Contribution to journalArticle

2 Scopus citations


Objectives: To differentiate apoptotic crypt abscesses (ACAs) from neutrophilic crypt abscesses (NCAs). Methods: Cases with crypt abscesses were classified as containing ACAs, NCAs, or mixed crypt abscesses (MCAs) by H&E staining. Sections were stained with cleaved caspase 3 and myeloperoxidase and recategorized. Results: Fifty-nine cases were reviewed: Inflammatory bowel disease (IBD; n = 33), acute cellular rejection (n = 5), graft vs host disease (GVHD; n = 14), cytomegalovirus (n = 5), and drug reaction (n = 2). Concordance was seen in 59%, with most reclassifications resulting from a change of ACAs to MCAs. When cases were classified as having NCA vs those with apoptosis (ACA and MCA), there was 85% agreement (P < .01). NCAs were present in IBD (96%) and not in GVHD or drug injury. Crypt abscesses with apoptosis were seen in 18% of IBD and 96% of non-IBD cases. Conclusions: ACAs and MCAs can be distinguished from NCAs and may be a diagnostically useful finding.

Original languageEnglish (US)
Pages (from-to)538-544
Number of pages7
JournalAmerican journal of clinical pathology
Issue number6
StatePublished - Dec 1 2017


  • Acute cellular rejection
  • Apoptosis
  • GVHD
  • Gastrointestinal pathology
  • Inflammatory bowel disease
  • Mycophenolate mofetil

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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