Difference between revisions of "Celiac sprue"

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Most pathologists do not grade celiac sprue.
Most pathologists do not grade celiac sprue.


The most common system is the ''Marsh system'' (abbreviated):<ref>{{cite journal |author=Oberhuber G, Granditsch G, Vogelsang H |title=The histopathology of coeliac disease: time for a standardized report scheme for pathologists |journal=Eur J Gastroenterol Hepatol |volume=11 |issue=10 |pages=1185–94 |year=1999 |month=October |pmid=10524652 |doi= |url=}}</ref><ref name=pmid12145668>{{cite journal |author=Wahab PJ, Meijer JW, Dumitra D, Goerres MS, Mulder CJ |title=Coeliac disease: more than villous atrophy |journal=Rom J Gastroenterol |volume=11 |issue=2 |pages=121–7 |year=2002 |month=June |pmid=12145668 |doi= |url=}}</ref>
The most common system is the ''Marsh system'' (abbreviated):<ref name=pmid10524652>{{cite journal |author=Oberhuber G, Granditsch G, Vogelsang H |title=The histopathology of coeliac disease: time for a standardized report scheme for pathologists |journal=Eur J Gastroenterol Hepatol |volume=11 |issue=10 |pages=1185–94 |year=1999 |month=October |pmid=10524652 |doi= |url=}}</ref><ref name=pmid12145668>{{cite journal |author=Wahab PJ, Meijer JW, Dumitra D, Goerres MS, Mulder CJ |title=Coeliac disease: more than villous atrophy |journal=Rom J Gastroenterol |volume=11 |issue=2 |pages=121–7 |year=2002 |month=June |pmid=12145668 |doi= |url=}}</ref>
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The ''Marsh system'' (full):<ref>{{cite journal |author=Oberhuber G, Granditsch G, Vogelsang H |title=The histopathology of coeliac disease: time for a standardized report scheme for pathologists |journal=Eur J Gastroenterol Hepatol |volume=11 |issue=10 |pages=1185–94 |year=1999 |month=October |pmid=10524652 |doi= |url=}}</ref>
The ''Marsh system'' (full):<ref name=pmid10524652>{{cite journal |author=Oberhuber G, Granditsch G, Vogelsang H |title=The histopathology of coeliac disease: time for a standardized report scheme for pathologists |journal=Eur J Gastroenterol Hepatol |volume=11 |issue=10 |pages=1185–94 |year=1999 |month=October |pmid=10524652 |doi= |url=}}</ref>
{| class="wikitable"
{| class="wikitable"
| Marsh score
| Marsh score
| Descriptors
| Descriptors
| Alternate descriptors
| Villi
| Intraepithelial <Br>lymphocytes (IELs)
| Crypts
| Crypts
| IEL
|-
|-
| Marsh 0
| Normal (Marsh 0)
| Well-formed villi
| normal
| Normal villous arch.
| normal villi
|
| '''< 40 / 100 epithelial cells'''
|
| normal crypts
|-
|-
| Marsh 1
| Marsh 1
| Well-formed villi
| IEL increased
| Normal villous arch.
| normal villi
|
| '''> 40 / 100 epithelial cells'''
|
| '''normal crypts'''
|-
|-
| March 2
| March 2
| Well-formed villi
| well-formed villi / normal villous arch.
| Normal villous arch.
| '''normal villi'''
|
| > 40 / 100 epithelial cells
|
| '''hypertrophic crypts'''
|-
|-
| Marsh 3A
| Marsh 3A
| Partial villous atrophy
| partial villous atrophy / blunted villi (mild)
| Blunted villi
| '''mild atrophy'''
|
| > 40 / 100 epithelial cells
|
| hypertrophic crypts
|-
|-
| Marsh 3B
| Marsh 3B
| Partial villous atrophy
| moderate-to-marked villous atrophy /<br> blunted villi (moderate-to-marked)
| Blunted villi
| '''marked atrophy'''
|
| > 40 / 100 epithelial cells
|
| hypertrophic crypts
|-
|-
| Marsh 3C
| Marsh 3C
| Total villous atrophy
| total villous atrophy, flattened mucosa
| Flattened mucosa
| '''absent'''; flat as a pancake
|
| > 40 / 100 epithelial cells
|
| hypertrophic crypts
|}
|}


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