Histopathologic Evaluation and Reporting in Inflammatory Bowel Disease: A Consensus Document Sponsored by the Rodger C. Haggitt Gastrointestinal Pathology Society.

The histopathologic evaluation and diagnosis of specimens from patients with inflammatory bowel diseases (IBDs), including ulcerative colitis and Crohn disease, is complicated, yet clinically important. Therefore, formalized recommendations about appropriate terminology and necessary elements to include in the corresponding report are likely to benefit practicing pathologists. This consensus document was initiated and sponsored by the Rodger C. Haggitt Gastrointestinal Pathology Society after the majority of respondents in a survey indicated that IBD reporting guidelines would inform their daily practice. The document presented herein provides recommendations for the macroscopic and histologic examination of samples from patients with suspected or confirmed IBD at 3 distinct tiers of disease evolution: initial diagnosis with endoscopic biopsies, assessment of disease activity during colonoscopic surveillance, and evaluation of long-term prognosis after surgery. Given its complexity and importance, IBD-related neoplasia will be considered in a separate, forthcoming document. These recommendations, presented as 20 main position statements, each following a brief review of the pertinent literature and some with additional supplemental statements, reflect the strength of available published evidence. They were subjected to review, voting, and approval by all authors and, in addition, by a group of surgical pathologists and gastroenterologists with documented interest and experience in the diagnosis and treatment of patients with IBD. We hope this document is the first in a dynamic series with subsequent iterations and revisions incorporating emerging data and evolving approaches to management.