Paneth cell

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Paneth cell metaplasia and lamina propria eosinophils. H&E stain.

The Paneth cell is characteristic of the small intestine. It is also normal in the cecum, ascending colon and transverse colon.

Paneth cell metaplasia, abbreviated PCM, redirects to this article.

General

  • Paneth cells should not be in the left colon.[1]
    • If you see 'em there it is Paneth cell metaplasia.

Paneth cell metaplasia

If PCM is present:

  • Think of inflammatory bowel disease and other long-standing injurious processes.
  • PCM in the context of colorectal adenomas may be associated with a higher risk of colorectal neoplasia.[2]

Microscopic

Features:

  • Supranuclear eosinophilic granules.

DDx:

  • Enterochromaffin cells (AKA Kulchitsky cells).
    • Subnuclear eosinophilic granules.
  • Intraepithelial eosinophils.
    • Eosinophils have smaller (~1/2) more intensely red granules.

Images

IHC

  • Lysozyme +ve.[3]

See also

References

  1. Tanaka M, Saito H, Kusumi T, et al (December 2001). "Spatial distribution and histogenesis of colorectal Paneth cell metaplasia in idiopathic inflammatory bowel disease". J. Gastroenterol. Hepatol. 16 (12): 1353–9. PMID 11851832. http://www3.interscience.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0815-9319&date=2001&volume=16&issue=12&spage=1353.
  2. Pai, RK.; Rybicki, LA.; Goldblum, JR.; Shen, B.; Xiao, SY.; Liu, X. (Jan 2013). "Paneth cells in colonic adenomas: association with male sex and adenoma burden.". Am J Surg Pathol 37 (1): 98-103. doi:10.1097/PAS.0b013e318267b02e. PMID 23232853.
  3. Rubio CA, Nesi G (2003). "A simple method to demonstrate normal and metaplastic Paneth cells in tissue sections". In Vivo 17 (1): 67–71. PMID 12655793.