UC characteristically involves the large bowel, with intense inflammation usually concentrated in the mucosa and submucosa. Grossly, the colonic mucosa appears hyperemic, with loss of the normal vascular pattern.
Crohn's disease is characteristically noncontiguous, with intervening, or skipped, areas of normal mucosa. The ulcerations in Crohn's disease tend to be linear and often lead to the classic cobblestone appearance of the mucosa. In Crohn's disease, inflammation is usually transmural and tends to involve the entire gastrointestinal tract.
Microscopically, the inflammation in UC and Crohn's disease can appear similar, but noncaseating granulomas are present only in Crohn's disease (in 60% of Crohn's disease specimens; never present in UC specimens).
Learn more about the differential diagnosis of UC.
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Cite this: B.S. Anand. Fast Five Quiz: Ulcerative Colitis Signs and Symptoms - Medscape - Apr 29, 2022.