Colitis Cystica

Colitis cystica is the cystic dilatation of the mucous glands of the colon and can be classified as superficialis and profunda.

The cysts in colitis cystica superficialis are small, located in the mucosa, and distributed throughout the entire colon. Colitis cystica superficialis is often associated with vitamin deficiencies and tropical sprue, but can also be seen with terminal leukemia, thyrotoxicosis, uremia, and mercury poisoning.

Contrast enema shows multiple, small filling defects resembling pseudopolyposis extending from the rectum to the cecum.

The cysts in colitis cystica profunda may be large and are submucosal and primarily seen in the pelvic colon and rectum. A diffuse variety of colitis cystica profunda has also been described. It is thought that colitis cystica profunda is the result of herniation or extension of regenerating surface epithelium into the submucosa through mucosal ulcerations. This is supported by the fact that these submucosal cysts may be preceded by superficial mucosal ulcerations or chronic inflammation.

Contrast enema shows multiple, irregular, large filling defects in the rectum. The retrorectal space may be widened. Differential considerations include polyps, ulcerative colitis, pneumatosis intestinalis, endometriosis, and carcinoma.

References

• Ledesma-Medina J, Reid BS, Girdany BR. Colitis cystica profunda. AJR Am J Roentgenol. 1978 Sep;131(3):529-30.
• Morris MW, Wyatt AP. Colitis cystica superficialis. Proc R Soc Med. 1973 Sep;66(9):908-10.