My biopsy report showed a chronic ulcer with inflammatory infiltrate and architectural distortion. What could be the probable diagnosis?

Q. What does the biopsy report from my colonoscopy signify?

Answered by
Dr. Utkarsh Sharma
and medically reviewed by Dr. K Shobana
This is a premium question & answer published on Oct 20, 2022 and last reviewed on: Aug 07, 2023

Hello doctor,

I am a 37-year-old female. I have a history of Hashimoto's disease and spinal stenosis. It is of the large intestine. My symptoms before this included abdominal pain, RLQ and low midline, intermittent diarrhea, bloating, and at times inability to have a bowel movement, and weight loss of about 15 pounds. Pain and diarrhea have occurred in bouts several times over the years. The doctor noticed a few discrete ulcers on colonoscopy, but that is all I know from the report. My biopsy reports revealed chronic ulcer with inflammatory infiltrate and architectural distortion in the adjacent mucosa with mucosal fibrosis and reactive epithelium. Could you give me your differential diagnosis for the biopsy result from my colonoscopy? Kindly help.



Welcome to

Thank you for your query. I understand your concern. Your biopsy report is inconclusive and of little help in reaching a specific diagnosis. However, the chronicity and clinical symptoms you have described lead to the differentials between inflammatory bowel disease and indeterminate colitis. Laboratory investigations are non-specific, but the following tests will aid in diagnosing IBD (inflammatory bowel disease). IBD is a complex disease involving complex immune mechanisms, and there are remissions and bouts in tandem. So I suggest you to do the following investigations. Check ESR (erythrocyte sedimentation rate). Check CRP (C-reactive protein) levels. Check fecal calprotectin levels. Check ANCA (antineutrophil cytoplasmic antibodies) tests. I hope this has helped you. Thank you.

Hello doctor,

Thank you for your reply. Can it be non-specific? Kindly help.



Welcome back to

Too high levels of fecal calprotectin will favor IBD. ANCA positivity will also favor IBD; raised ESR and CRP are too non-specific. Now intestinal tuberculosis can be ruled out on account of the biopsy description. A malignancy is highly unlikely at this stage as biopsy reveals no such features, and there is no wall thickening or discrete mass. Undergoing a USG (ultrasonography) and CT (computed tomography) would have been better, though. If you respond to the immunomodulator drugs, the diagnosis is confirmed, and other entities are automatically ruled out. I hope this has helped you. Thank you.

Was this answer helpful?


Same symptoms doesn’t mean you have the same problem. Consult a doctor now!

Related Questions:
Can someone with Hashimoto's disease plan for pregnancy?

Also, I do not have symptoms of hypothyroidism ...   Read full

Can MRSA cause spinal stenosis?

I am 46 years old and very active and I have never had muscle or back pain and now all of a sudden neurologist is saying I have radiculopathy and MRI showing severe spinal stenosis in multiple pl   Read full

My mother has cervical spinal stenosis. How to move her from the bed to wheelchair?

But, in a bed bound person, one needs to take care that she does not develop pressure sores in the back and any chest or urinary infection ... Hi, Welcome back to icliniq ... Her symptoms are mus   Read full

Also Read Answers From:

ideaComprehensive Medical Second Opinion.Submit your Case

Also Read

PCOS and Liver Problems
The hormonal imbalances in polycystic ovary syndrome could cause liver diseases. Read the article to know the relationship between these medical conditions.  Read more»
Inferior Alveolar Nerve Lateralization Technique
The inferior alveolar nerve lateralization technique is a surgical lateralization technique to reposition the nerve. Read the article to know more about this.  Read more»
COVID-19 and Ebola: Similarities and Differences
This article gives a comparison and broader overview of the outbreak of the two deadliest diseases that showed a greater incidence over the last two decades.  Read more»

Ask your health query to a doctor online?

Ask a Pathologist Now

* guaranteed answer within 4 hours.

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.