Which of the following is a classic microscopic feature of 'chronic' IBD that indicates long-standing injury?
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Correct answer: Paneth cell metaplasia in the left colon
Paneth cell metaplasia (the appearance of Paneth cells where they don't belong, such as the distal colon) and crypt architectural distortion (branching/shortening) are markers of chronic, repeated cycles of injury and repair in IBD.
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