PMC9761328_01
Colonoscopy findings of vismodegib-induced diarrhea showing (A) ilium with mucosal edema and granularity, (B) transverse colon with mildly granular mucosa and loss of vascular pattern, and (C) descending colon showing mildly granular mucosa with loss of vascular pattern.
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Colonic edema, granularity, and a diffuse loss of vascular pattern were found (Fig 1).
Microscopic findings of vismodegib-induced diarrhea in the ileum. Ileum biopsy sepcimens showing (A) mild villous blunting, (B) focal epithelial apoptosis (yellow arrows) and active ileitis (red arrow), and (C) focal active ileitis. A to C, Hematoxylin-eosin stain; original magnifications: A, x10; B, x40; C, x40.
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Epithelial apoptosis of the crypts was noted (Fig 2).
Microscopic findings of vismodegib-induced diarrhea in the colon. Colon biopsy sepcimen showing (A) the right colon with mild crypt branching and irregularity; (B) the right colon with epithelial apoptosis and mildly increased eosinophils (the yellow arrow highlights a focus of epithelial apoptosis); (C) the left colon with active inflammation with neutrophils and eosinophils within an atrophic crypt, (D) the left colon with Paneth cell metaplasia, indicative of chronic damage; (E) the rectum demonstrating architectural distortion with crypt branching and irregular crypts; (F) the rectum demonstrating that epithelial apoptosis was present (yellow arrows highlights foci of epithelial apoptosis). A to F, Hematoxylin-eosin stain; original magnifications: A, x10; B, x40; C, x40; D, x40; E, x10; F, x40.
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Biopsies of the right colon, left colon, and rectum showed various degrees of crypt architectural distortion, mixed inflammation, epithelial apoptosis, and a crypt abscess (Fig 3).