Difference between revisions of "Talk:Intraepithelial lymphocytes"

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Small Bowel, Excision During Gastric Bypass:
Small Bowel, Excision during Gastric Bypass:
- Small bowel wall with increased intraepithelial lymphocytes, otherwise within normal limits, see comment.
- Small bowel wall with increased intraepithelial lymphocytes, otherwise within normal limits, see comment.


Comment:
Comment:
The increased intraepithelial lymphocytes are likely explained by obesity; however, other causes (such as infection, inflammatory bowel disease and celiac disease) should be considered with the clinical context.  
The increased intraepithelial lymphocytes are likely explained by obesity; however, other causes (such as infection, inflammatory bowel disease and celiac disease) should be considered within the clinical context.  
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==Focally increased==
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Small Bowel, Excision during Obesity Surgery:
Small Bowel, Excision during Gastric Bypass:
- Small bowel wall with increased intraepithelial lymphocytes, otherwise within normal limits, see comment.
    - Small bowel wall with focally increased intraepithelial lymphocytes,  
      otherwise within normal limits, see comment.


Comment:
Comment:
The focal increased intraepithelial lymphocytes are favoured to be a reactive phenomenon; however, clinical correlation is suggested.
The focally increased intraepithelial lymphocytes may be explained by obesity.  
 
Immunostains show that the lymphocytes are predominantly T cells (CD3 >> CD20).
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==Longer DDx==
Small Bowel, Excision During Gastric Bypass: 
Potential causes of increased duodenal IELs include celiac disease, gastric Helicobacter infection (not seen), giardia (not seen), stasis/bacterial overgrowth, post-infectious states including post-viral gastroenteritis (which can spontaneously resolve), medications (such as NSAIDs and olmesartan), wheat-protein allergy (usually TTG negative), tropical sprue, agammaglobulinemia (unlikely as plasma cells present) and other protein allergies.
    - Small bowel wall with increased intraepithelial lymphocytes,  
      otherwise within normal limits.
 
Comment:
The significance of the increased intraepithelial lymphocytes is unknown. Clinical correlation is suggested.
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<pre>
Small Bowel, Excision During Gastric Bypass: 
    - Small bowel wall with increased intraepithelial lymphocytes,  
      otherwise within normal limits.
 
Comment:
The significance of the increased intraepithelial lymphocytes (IELs) is unknown. Causes of IELs (infection, inflammatory bowel disease, celiac disease) should be considered clinically.  
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Latest revision as of 15:56, 4 October 2023

Small Bowel, Excision during Gastric Bypass:
	- Small bowel wall with increased intraepithelial lymphocytes, otherwise within normal limits, see comment.

Comment:
The increased intraepithelial lymphocytes are likely explained by obesity; however, other causes (such as infection, inflammatory bowel disease and celiac disease) should be considered within the clinical context.


Focally increased

Small Bowel, Excision during Gastric Bypass:
     - Small bowel wall with focally increased intraepithelial lymphocytes, 
       otherwise within normal limits, see comment.

Comment:
The focally increased intraepithelial lymphocytes may be explained by obesity.

Longer DDx

Potential causes of increased duodenal IELs include celiac disease, gastric Helicobacter infection (not seen), giardia (not seen), stasis/bacterial overgrowth, post-infectious states including post-viral gastroenteritis (which can spontaneously resolve), medications (such as NSAIDs and olmesartan), wheat-protein allergy (usually TTG negative), tropical sprue, agammaglobulinemia (unlikely as plasma cells present) and other protein allergies.

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