{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T09:19:02Z","timestamp":1787649542817,"version":"build-2736575974"},"reference-count":78,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Surg Pathol"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ileal biopsies represent a critical diagnostic tool in gastroenterological practice, with particular relevance in the evaluation of Crohn's disease (CD). However, the ileal mucosa can harbor numerous nonneoplastic and neoplastic conditions that may clinically and histologically mimic CD. Accurate interpretation requires a nuanced understanding of normal ileal histology and its variants, alongside a structured diagnostic algorithm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To delineate the spectrum of pathologic processes affecting the ileum and establish a systematic diagnostic approach, while highlighting potential diagnostic pitfalls and intrinsic limitations of biopsy interpretation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a MEDLINE literature review focusing on ileal pathology, supplemented with clinical-pathologic insights derived from institutional experience. Key diagnostic criteria, differential considerations, and evolving concepts were critically analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The ileum is implicated in a wide range of conditions beyond CD, including tropical sprue, eosinophilic enteritis, graft-versus-host disease, tuberculosis, and various neoplasms, including metastatic lesions. Drug-induced injuries, particularly those associated with nonsteroidal anti-inflammatory drugs and immunotherapy agents, are increasingly recognized as important differential diagnoses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A systematic histologic evaluation of ileal biopsy specimens\u2014integrated with the patient's clinical presentation, endoscopic findings, and imaging studies\u2014is paramount for accurate diagnosis. This approach minimizes diagnostic errors, particularly when distinguishing between conditions with overlapping features, such as CD and other inflammatory or neoplastic processes. Recognizing histologic variations and adopting a comprehensive diagnostic strategy can significantly improve diagnostic yield and inform appropriate management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10668969251385989","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T18:15:23Z","timestamp":1763403323000},"page":"577-602","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["A Systematic Approach to the Histologic Evaluation of Terminal Ileal Biopsies"],"prefix":"10.1177","volume":"34","author":[{"given":"Rifat","family":"Mannan","sequence":"first","affiliation":[{"name":"City of Hope"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7102-3096","authenticated-orcid":false,"given":"Sanjay A.","family":"Pai","sequence":"additional","affiliation":[{"name":"Manipal Hospital-Yeshwanthpur"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0016-5107(72)73931-0"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0016-5107(84)72358-3"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01194.x"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.3109\/00313020903494979"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2010.08.004"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1590\/s0102-67202014000300006"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2015-0305-RA"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-010-0112-5"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-018-0651-8"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2559.2001.01070.x"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.4103\/0377-4929.155302"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.30699\/IJP.2022.539357.2736"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/PAP.0000000000000318"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjad142"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/his.12522"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1309\/V1GCW4DHTHM9WVXJ"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1080\/00365520410004901"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.crohns.2010.05.010"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.00587"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2014.02.007"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.20524\/aog.2020.0518"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1309\/4PK0-G68M-2G1L-6X47"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-017-4803-8"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.39677"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00508-019-01539-2"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/10668969221076549"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.18085"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1136\/jcp-2024-209477"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-015-1803-y"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2018.1535118"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1097\/pas.0b013e31816bf3fe"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e31829ab1ef"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000002071"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1136\/jcp-2024-209621"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3180cab60c"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1111\/his.13118"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.modpat.2023.100325"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.14670\/HH-18-167"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1136\/gut.28.4.394"},{"issue":"1","key":"e_1_3_3_41_2","first-page":"87","article-title":"Thickening of muscularis mucosae in Crohn's disease","volume":"4","author":"Lee EY","year":"1991","unstructured":"Lee EY, Stenson WF, DeSchryver-Kecskemeti K. 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