Behçet's Colitis Has Distinctive Pathological Features

Patients with Behcet's syndrome commonly have gastrointestinal symptoms. Less commonly, these symptoms are so severe as to necessitate surgery. The features of the colitis seen in Behcet's syndrome are not clearly defined histologically, and their similarity to Crohn's disease is often emphasized. After reviewing three cases with Behcet's colitis we feel that there is a specific constellation of gross and histologic features that, when combined with a relevant clinical history, should suggest Behcet's colitis. On gross examination Behcet's colitis is characterized by multiple punchedout ulcers of varying sizes with intervening normal mucosa. This appearance excludes ulcerative colitis, which should have adjacent architectural distortion with active inflammation, but not Crohn's disease, infectious colitis, or druginduced colitis. On histologic examination Behcet's colitis has cratershaped ulcers that often penetrate the serosa. Fissure ulcers, mural lymphoid aggregates, and granulomas are not seen in cont...