Small intestine in celiac disease
Author:
Mikael Häggström [note 1]
Contents
Gross processing
As per Small intestine.
Microscopic evaluation
The main histologic feature of celiac disease is increased intraepithelial lymphocytes (IELs), with or without villous atrophy of the duodenal mucosa.[1] The number of intraepithelial lymphocytes are classified as follows in the duodenum:[2][3]
- < 25 IELs/100 enterocytes: Negative for intraepithelial lymphocytosis.
- 25 to 29 IELs/100 enterocytes: borderline
- > 30 IEL/100 enterocytes: Pathological "lymphocytosis"
Alternative proposed methods is the presence of over 6-12 IELs per 20 enterocytes at the tips of duodenal villi.[3] In the jejunum, the cutoff is at over 40 IELs per 100 enterocytes.[3]
Suggestive but not specific findings for enterocytes are: decreased height, intracytoplasmic vacuolation and reduction or absence of the brush border.[2]
Differential diagnoses
If findings are suggestive of celiac disease, look for at least the following differential diagnoses:
Giardia lamblia: Organisms shaped like teardropd or pears, with paired nuclei, seen in the lumen between villi.[4]
Microscopy report
Example in an unremarkable specimen:
Duodenal mucosa, negative for significant histopathologic changes. Negative for celiac disease. |
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
Main page
References
- ↑ Brown, Ian S.; Smith, Jason; Rosty, Christophe (2012). "Gastrointestinal Pathology in Celiac Disease ". American Journal of Clinical Pathology 138 (1): 42–49. doi: . ISSN 0002-9173.
- ↑ 2.0 2.1 Erdener Özer. Small intestine & ampulla, Malabsorption, Celiac sprue. Pathology Outlines. Topic Completed: 1 June 2017. Minor changes: 4 April 2020.
- ↑ 3.0 3.1 3.2 . Celiac Disease. Stanford School of Medicine. Retrieved on 2021-03-11.
- ↑ Hanni Gulwani. Small intestine & ampulla - Infectious disorders - Giardia lamblia. Pathology Outlines. Topic Completed: 1 August 2012. Minor changes: 3 March 2020
Image sources