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[[Image:Small intestine low mag.jpg|thumb|250px|right|Small bowel mucosa. [[H&E stain]].]] | |||
The '''small intestine''', also '''small bowel''', is a relatively well-behaved piece of machinery from the perspective of [[pathology]]. It is uncommonly affected by malignancies, relative to its length when compared to the [[colon]] and [[rectum]]. | The '''small intestine''', also '''small bowel''', is a relatively well-behaved piece of machinery from the perspective of [[pathology]]. It is uncommonly affected by malignancies, relative to its length when compared to the [[colon]] and [[rectum]]. | ||
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===Sign out=== | ===Sign out=== | ||
<pre> | |||
Small Bowel, Biopsy: | |||
- Small bowel mucosa within normal limits. | |||
</pre> | |||
<pre> | |||
Terminal Ileum, Biopsy: | |||
- Small bowel mucosa within normal limits. | |||
</pre> | |||
<pre> | |||
Terminal Ileum, Biopsy: | |||
- Small bowel mucosa with morphologically benign lymphoid aggregates, negative for significant pathology. | |||
</pre> | |||
====Roux-en-Y gastric bypass==== | |||
{{Main|Obese}} | |||
{{Main|Roux-en-Y gastric bypass}} | |||
====Block letters==== | |||
<pre> | <pre> | ||
SMALL BOWEL, BIOPSY: | SMALL BOWEL, BIOPSY: | ||
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**[[Crohn's disease]] and[[ulcerative colitis]] are discussed in their respective articles. | **[[Crohn's disease]] and[[ulcerative colitis]] are discussed in their respective articles. | ||
=Specific | =Specific diagnoses= | ||
== | ==Ileitis== | ||
:''Active ileitis'' and ''acute ileitis'' redirect here. | |||
:This | :This deals with nonspecific ileitis. | ||
===General=== | ===General=== | ||
* | *Common. | ||
===Microscopic=== | ===Microscopic=== | ||
Features: | Features: | ||
* | *Intraepithelial [[neutrophil]]s. | ||
DDx: | DDx: | ||
* | *[[Crohn's disease]]. | ||
* | *Infectious ileitis. | ||
*[[ | **[[Tuberculosis]]. | ||
*Benign ileum - may have focal intra-epithelial lymphocytes associated with lamina propria lymphoid nodules. | |||
*[[NSAID enteropathy]].<ref name=pmid20532706>{{Cite journal | last1 = Dilauro | first1 = S. | last2 = Crum-Cianflone | first2 = NF. | title = Ileitis: when it is not Crohn's disease. | journal = Curr Gastroenterol Rep | volume = 12 | issue = 4 | pages = 249-58 | month = Aug | year = 2010 | doi = 10.1007/s11894-010-0112-5 | PMID = 20532706 }}</ref> | |||
====Images==== | |||
<gallery> | |||
Image: Mild ileitis -- very low mag.jpg | Ileitis - very low mag. (WC) | |||
Image: Mild ileitis -- low mag.jpg | Ileitis - low mag. (WC) | |||
Image: Mild ileitis -- intermed mag.jpg | Ileitis - intermed. mag. (WC) | |||
Image: Mild ileitis -- high mag.jpg | Ileitis - high mag. (WC) | |||
</gallery> | |||
===Sign out=== | ===Sign out=== | ||
<pre> | <pre> | ||
Terminal Ileum, Biopsy: | |||
- | - Small bowel with moderate active inflammation, marked villous blunting, basal plasmacytosis | ||
and prominent eosinophils, see comment. | |||
- NEGATIVE | - NEGATIVE for granulomas. | ||
- NEGATIVE for dysplasia. | |||
Comment: | |||
The inflammation is nonspecific; it could be due to infection, inflammatory bowel disease (especially Crohn's disease), ischemia, or therapy/drugs. Clinical correlation is required. | |||
</pre> | </pre> | ||
==== | ==Small bowel obstruction== | ||
*Abbreviated ''SBO''. | |||
{{Main|Small bowel obstruction}} | |||
==Small bowel neoplasms== | ==Small bowel neoplasms== | ||
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*[[Schwannoma]]. | *[[Schwannoma]]. | ||
**Classically have a ''peripheral lymphoid cuff''.<ref name=pmid15728600>{{cite journal |author=Levy AD, Quiles AM, Miettinen M, Sobin LH |title=Gastrointestinal schwannomas: CT features with clinicopathologic correlation |journal=AJR Am J Roentgenol |volume=184 |issue=3 |pages=797–802 |year=2005 |month=March |pmid=15728600 |doi= |url=http://www.ajronline.org/cgi/content/full/184/3/797}}</ref> | **Classically have a ''peripheral lymphoid cuff''.<ref name=pmid15728600>{{cite journal |author=Levy AD, Quiles AM, Miettinen M, Sobin LH |title=Gastrointestinal schwannomas: CT features with clinicopathologic correlation |journal=AJR Am J Roentgenol |volume=184 |issue=3 |pages=797–802 |year=2005 |month=March |pmid=15728600 |doi= |url=http://www.ajronline.org/cgi/content/full/184/3/797}}</ref> | ||
==Mechanical small bowel perforation== | |||
:See ''[[mechanical bowel perforation]]''. | |||
==Ileal nodular lymphoid hyperplasia== | ==Ileal nodular lymphoid hyperplasia== | ||
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===IHC=== | ===IHC=== | ||
*CD20 and CD3 - mixed population of lymphocytes. | *[[CD20]] and CD3 - mixed population of lymphocytes. | ||
*[[CD23]] - follicular dendritic cells. | *[[CD23]] - follicular dendritic cells. | ||
*Cyclin D1 -ve. | *Cyclin D1 -ve. | ||
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DDx: | DDx: | ||
*Cryptogenic multifocal ulcerous stenosing enteritis.<ref>{{Cite journal | last1 = Chung | first1 = SH. | last2 = Jo | first2 = Y. | last3 = Ryu | first3 = SR. | last4 = Ahn | first4 = SB. | last5 = Son | first5 = BK. | last6 = Kim | first6 = SH. | last7 = Park | first7 = YS. | last8 = Hong | first8 = YO. | title = Diaphragm disease compared with cryptogenic multifocal ulcerous stenosing enteritis. | journal = World J Gastroenterol | volume = 17 | issue = 23 | pages = 2873-6 | month = Jun | year = 2011 | doi = 10.3748/wjg.v17.i23.2873 | PMID = 21734797 }}</ref> (???) | |||
*[[Crohn's disease]]. | *[[Crohn's disease]]. | ||
==Meckel diverticulum== | ==Meckel diverticulum== | ||
{{Main|Meckel diverticulum}} | |||
==Ischemic enteritis== | ==Ischemic enteritis== | ||
{{Main|Ischemic enteritis}} | |||
=Weird stuff= | =Weird stuff= | ||
==Autoimmune enteropathy== | ==Autoimmune enteropathy== | ||
*Abbreviated as ''AIE''. | *Abbreviated as ''AIE''. | ||
{{Main|Autoimmune enteropathy}} | |||
=See also= | =See also= |
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