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Difference between revisions of "Celiac sprue"
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Most pathologists do not grade celiac sprue. | Most pathologists do not grade celiac sprue. | ||
The most common system is the ''Marsh system'' (abbreviated):<ref>{{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=pmid12145668>{{cite journal |author=Wahab PJ, Meijer JW, Dumitra D, Goerres MS, Mulder CJ |title=Coeliac disease: more than villous atrophy |journal=Rom J Gastroenterol |volume=11 |issue=2 |pages=121–7 |year=2002 |month=June |pmid=12145668 |doi= |url=}}</ref> | The most common system is the ''Marsh system'' (abbreviated):<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=pmid12145668>{{cite journal |author=Wahab PJ, Meijer JW, Dumitra D, Goerres MS, Mulder CJ |title=Coeliac disease: more than villous atrophy |journal=Rom J Gastroenterol |volume=11 |issue=2 |pages=121–7 |year=2002 |month=June |pmid=12145668 |doi= |url=}}</ref> | ||
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The ''Marsh system'' (full):<ref>{{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> | The ''Marsh system'' (full):<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> | ||
{| class="wikitable" | {| class="wikitable" | ||
| Marsh score | | Marsh score | ||
| Descriptors | | Descriptors | ||
| | | Villi | ||
| Intraepithelial <Br>lymphocytes (IELs) | |||
| Crypts | | Crypts | ||
|- | |- | ||
| Marsh 0 | | Normal (Marsh 0) | ||
| | | normal | ||
| | | normal villi | ||
| | | '''< 40 / 100 epithelial cells''' | ||
| | | normal crypts | ||
|- | |- | ||
| Marsh 1 | | Marsh 1 | ||
| | | IEL increased | ||
| | | normal villi | ||
| | | '''> 40 / 100 epithelial cells''' | ||
| | | '''normal crypts''' | ||
|- | |- | ||
| March 2 | | March 2 | ||
| | | well-formed villi / normal villous arch. | ||
| '''normal villi''' | |||
| | | > 40 / 100 epithelial cells | ||
| | | '''hypertrophic crypts''' | ||
|- | |- | ||
| Marsh 3A | | Marsh 3A | ||
| | | partial villous atrophy / blunted villi (mild) | ||
| | | '''mild atrophy''' | ||
| | | > 40 / 100 epithelial cells | ||
| | | hypertrophic crypts | ||
|- | |- | ||
| Marsh 3B | | Marsh 3B | ||
| | | moderate-to-marked villous atrophy /<br> blunted villi (moderate-to-marked) | ||
| | | '''marked atrophy''' | ||
| | | > 40 / 100 epithelial cells | ||
| | | hypertrophic crypts | ||
|- | |- | ||
| Marsh 3C | | Marsh 3C | ||
| | | total villous atrophy, flattened mucosa | ||
| | | '''absent'''; flat as a pancake | ||
| | | > 40 / 100 epithelial cells | ||
| | | hypertrophic crypts | ||
|} | |} | ||