Division of Gastrointestinal and Liver Pathology
Case Conference

Case prepared by: Baishali Bhattacharya, MD, MPH
GI Pathology Fellow
Attending: Christine Iacobuzio-Donahue, M.D., Ph.D.
  Case 9
Clinical History: Images 1 and 2 are biopsies of the splenic flexure of a 74-year-old white male with ischaemic cardiomyopathy, and an ejection fraction of 15%. His hospital course was complicated by acute renal failure and heme- positive stools. Colonoscopy revealed mucosal erythema, friability and patchy ulceration at the splenic flexure.

Images 3 and 4 are colonic biopsies of a 60-year-old male status post renal transplant, who presented with gastrointestinal bleeding, uremic symptoms and was started on hemodialysis.

Image 1 Image 1
Image 2 Image 2
Image 3 Image 3
Image 4 Image 4
Choose the correct diagnosis:
  a. Clostridium difficile colitis
  b. Collagenous colitis
  c. Ischaemic colitis
  d. Ischaemic colitis/necrosis with Kayexalates
  e. Amyloidosis

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