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Difference between revisions of "Duodenum"
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→Getting started
m (/* Infectious of the duodenum{{cite journal |author=Serra S, Jani PA |title=An approach to duodenal biopsies |journal=J. Clin. Pathol. |volume=59 |issue=11 |pages=1133–50 |year=2006 |month=November |pmid=16679353 |pmc=1860495 |doi=10.1136/jcp.2005.) |
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==Getting started== | ==Getting started== | ||
=== | ===Normal duodenum=== | ||
*Three tall villi. | |||
*Few intraepithelial lymphocytes; < 1 lymphocyte / 4 epithelial cells. | |||
*No (pink) subepithelial collagen band. | |||
*Predominant lamina propria cell: plasma cells. | |||
**Lack of plasma cells suggests ''common variable immunodeficiency'' (CVID).<ref name=pmid20629103>{{cite journal |author=Agarwal S, Smereka P, Harpaz N, Cunningham-Rundles C, Mayer L |title=Characterization of immunologic defects in patients with common variable immunodeficiency (CVID) with intestinal disease |journal=Inflamm Bowel Dis |volume= |issue= |pages= |year=2010 |month=July |pmid=20629103 |doi=10.1002/ibd.21376 |url=}}</ref> | |||
*No organisms in lumen. | |||
===Basic DDx=== | |||
*Celiac. | *Celiac. | ||
**Intraepithelial lymphocytes - '''key feature'''. | **Intraepithelial lymphocytes - '''key feature'''. | ||
| Line 17: | Line 25: | ||
**Too much blue and epithelium in the wrong place. | **Too much blue and epithelium in the wrong place. | ||
=== | ===Duodenal nodules DDX=== | ||
{{familytree/start}} | |||
{{familytree | | | | | | | | | | | | | A01 | | | | | | | | | | | | | | | | | | | | |A01=Duodenal<br>nodule}} | |||
{{familytree | | | | | |,|-|-|-|-|-|-|-|^|-|-|-|-|-|-|-|.| | | | | | | | | | | | | |}} | |||
{{familytree | | | | | B01 | | | | | | | | | | | | | | B02 | | | | | | | | | | | | |B01=Benign<br>(common)| B02=Neoplastic}} | |||
{{familytree | |,|-|-|-|+|-|-|-|.| | | |,|-|-|-|v|-|-|-|+|-|-|-|v|-|-|-|.| | | | | |}} | |||
{{familytree | C01 | | C02 | | C03 | | C04 | | C05 | | C06 | | C07 | | C08 | | | | |C01=Brunner's<br>gland|C02=Heterotopic<br>gastric mucosa|C03=Lymphoid<br>nodule|C04=Adenoma|C05=NET|C06=Paraganglioma|C07=Prolapsed<br>gastric polyp|C08=Metastasis}} | |||
{{familytree/end}} | |||
===Infections of the duodenum<ref>{{cite journal |author=Serra S, Jani PA |title=An approach to duodenal biopsies |journal=J. Clin. Pathol. |volume=59 |issue=11 |pages=1133–50 |year=2006 |month=November |pmid=16679353 |pmc=1860495 |doi=10.1136/jcp.2005.031260 |url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1860495/?tool=pubmed}}</ref>=== | |||
Common: | Common: | ||
*Giardia | *Giardia | ||
| Line 28: | Line 45: | ||
*CMV (cytomegalovirus). | *CMV (cytomegalovirus). | ||
*Cryptococcus neoformans. | *Cryptococcus neoformans. | ||
==Celiac sprue== | ==Celiac sprue== | ||