Difference between revisions of "Duodenum"

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89 bytes added ,  03:37, 21 September 2010
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Features:<ref name=Ref_PBoD843>{{Ref PBoD|843}}</ref>
Features:<ref name=Ref_PBoD843>{{Ref PBoD|843}}</ref>
*Enteritis.  
*Enteritis.  
**Intraepithelial lymphocytes (IELs) - '''key feature'''.
**Intraepithelial lymphocytes - '''key feature'''.
**Plasma cells.
**Plasma cells.
**Macrophages.  
**Macrophages.  
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**Normal duodenal biopsy should have 3 good villi.
**Normal duodenal biopsy should have 3 good villi.
*Mitosis increased (in the crypts).
*Mitosis increased (in the crypts).
*+/-Collagen band (pink material in mucosa) - "Collagenous sprue"; must encompass ~25% of mucosa.


Image:
Image:
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*If you see acute inflammatory cells, i.e. neutrophils, consider Giardiasis and other infectious etiologies.
*If you see acute inflammatory cells, i.e. neutrophils, consider Giardiasis and other infectious etiologies.
*Biopsy should consist of 2-3 sites.  In children it is important to sample the duodenal cap, as it is the only affected site in ~10% of cases.
*Biopsy should consist of 2-3 sites.  In children it is important to sample the duodenal cap, as it is the only affected site in ~10% of cases.
*Flat lesions without IELs are unlikely to be celiac disease.
*Flat lesions without IELs are unlikely to be celiac sprue.


===Grading===
===Grading===
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