Prospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Feb 16, 2025; 17(2): 101284
Published online Feb 16, 2025. doi: 10.4253/wjge.v17.i2.101284
Discordance between endoscopic and histopathologic assessment in ileal Crohn’s disease
Scott D Lee, Brian Mau, Cody J Avalos, Kindra D Clark-Snustad, Kendra J Kamp, Xianyong Gui
Scott D Lee, Cody J Avalos, Kindra D Clark-Snustad, Kendra J Kamp, Department of Gastroenterology, School of Medicine, University of Washington, Seattle, WA 98195, United States
Brian Mau, Department of Pathology and Laboratory Medicine, Oregon Health and Science University, Portland, OR 97239, United States
Kendra J Kamp, Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA 98195, United States
Xianyong Gui, Department of Pathology, Wake Forest University School of Medicine Bowman Gray Center for Medical Education, Winston-Salem, NC 27101, United States
Xianyong Gui, Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA 98195, United States
Author contributions: Lee SD and Gui XY contributed to conceptualization, investigation, methodology, project administration, resources, supervision, validation, visualization, writing, review and editing; Mau B contributed to investigation, validation, visualization, writing, review and editing; Avalos CJ contributed to investigation, project administration, validation, visualization, writing, review and editing; Clark-Snustad KD and Kamp KJ contributed to data curation, formal analysis, investigation, methodology, project administration, software, validation, visualization, writing-original draft preparation, writing, review and editing.
Institutional review board statement: Institutional review board approval (University of Washington Human Subjects Division) was received for this prospective study.
Clinical trial registration statement: This study did not require clinical trial registration.
Informed consent statement: All subjects gave their written informed consent prior to study inclusion.
Conflict-of-interest statement: Scott Lee, MD: Consultant for Janssen, Eli Lilly, Boehringer Ingelheim, Bristol-Myers Squibb, Applied Molecular Transport, Protagonist, Pfizer, Celltrion; Kindra Clark-Snustad, DNP, ARNP: Consultant for Janssen, Takeda, Abbvie, Pfizer, BMS.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: Data are not available, but reasonable requests to the authors will be considered.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xianyong Gui, MD, Professor, Department of Pathology, Wake Forest University School of Medicine Bowman Gray Center for Medical Education, 475 Vine Street, Winston-Salem, NC 27101, United States. xgui@wakehealth.edu
Received: September 9, 2024
Revised: October 14, 2024
Accepted: November 5, 2024
Published online: February 16, 2025
Processing time: 156 Days and 4.1 Hours
Core Tip

Core Tip: Discordance exists between endoscopic and histologic assessments for mucosal inflammation in patients with active ileal Crohn’s disease (CD), even in biopsies targeted at an ulcer edge, while a higher concordance is seen in patients with no endoscopic disease activity. Microscopic patchiness of mucosal inflammation in CD likely contributes to the discrepancy. Given the discordance, ulcer and erosion should not be included in the histologic evaluation scheme for CD.