Abstract
A 61-year-old woman with a diagnosis of left-sided ulcerative colitis presented with recurrence of watery nonbloody diarrhea. She was status post liver transplant 2 years prior for primary sclerosing cholangitis, currently on tacrolimus and mesalamine. Following a negative Clostridium difficile polymerase chain reaction, colonoscopy demonstrated Mayo 1 appearance throughout the colon, with an area of friable and hemorrhagic mucosa in the cecum (Figure A). Random colon biopsies showed mild chronic active colitis, but specific biopsies of the cecal patch identified a monomorphous infiltrate of atypical lymphocytes (Figure B).
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