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Difference between revisions of "Celiac sprue"
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→Grading
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Most pathologists do not grade celiac sprue. | Most pathologists do not grade celiac sprue. | ||
The | The (full) ''Marsh system'', also ''Marsh-Oberhuber'':<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=pmid17544877>{{cite journal |author=Corazza GR, Villanacci V, Zambelli C, ''et al.'' |title=Comparison of the interobserver reproducibility with different histologic criteria used in celiac disease |journal=Clin. Gastroenterol. Hepatol. |volume=5 |issue=7 |pages=838–43 |year=2007 |month=July |pmid=17544877 |doi=10.1016/j.cgh.2007.03.019 |url=}}</ref> | ||
{| class="wikitable" | {| class="wikitable" | ||
| Marsh score | | Marsh score | ||
| Line 103: | Line 85: | ||
| '''hypertrophic crypts''' | | '''hypertrophic crypts''' | ||
|- | |- | ||
| Marsh | | Marsh 3a | ||
| partial villous atrophy / blunted villi (mild) | | partial villous atrophy / blunted villi (mild) | ||
| '''mild atrophy''' | | '''mild atrophy''' | ||
| Line 109: | Line 91: | ||
| hypertrophic crypts | | hypertrophic crypts | ||
|- | |- | ||
| Marsh | | Marsh 3b | ||
| moderate-to-marked villous atrophy /<br> blunted villi (moderate-to-marked) | | moderate-to-marked villous atrophy /<br> blunted villi (moderate-to-marked) | ||
| '''marked atrophy''' | | '''marked atrophy''' | ||
| Line 115: | Line 97: | ||
| hypertrophic crypts | | hypertrophic crypts | ||
|- | |- | ||
| Marsh | | Marsh 3c | ||
| total villous atrophy, flattened mucosa | | total villous atrophy, flattened mucosa | ||
| '''absent'''; flat as a pancake | | '''absent'''; flat as a pancake | ||
| Line 121: | Line 103: | ||
| hypertrophic crypts | | hypertrophic crypts | ||
|} | |} | ||
A modified ''Marsh system'' - based only on villous architecture:<ref name=pmid17544877>{{cite journal |author=Corazza GR, Villanacci V, Zambelli C, ''et al.'' |title=Comparison of the interobserver reproducibility with different histologic criteria used in celiac disease |journal=Clin. Gastroenterol. Hepatol. |volume=5 |issue=7 |pages=838–43 |year=2007 |month=July |pmid=17544877 |doi=10.1016/j.cgh.2007.03.019 |url=}}</ref> | |||
{| class="wikitable" | |||
| Grade (Marsh grade) | |||
| Descriptors | |||
| Alternate descriptors | |||
|- | |||
| A (Marsh 1) | |||
| well-formed villi, IELs > 25/100 enterocytes | |||
| normal villous architecture | |||
|- | |||
| B1 (Marsh 3a) | |||
| partial villous atrophy | |||
| blunted villi | |||
|- | |||
| B3 (Marsh 3c) | |||
| total villous atrophy | |||
| flattened mucosa | |||
|} | |||
Notes: | Notes: | ||