Talk:Celiac sprue

See also: Talk:Esophagus.

Celiac sprue

Microscopic description

A. The sections shows small bowel mucosa with Brunner's glands and a moderate number of intraepithelial lymphocytes (~30-40 lymphocytes/100 enterocytes). There is focal mild blunting of the villi and moderate crypt hyperplasia. The intraepithelial lymphocytes are more prominent at the tips of the villi. The lamina propria contains a moderate number of plasma cells and lymphocytes, and rare eosinophils. There is no dysplasia.
B. The sections show normal antral-type gastric mucsoa.
C. The sections show normal body-type gastric mucosa.
D. The sections show normal esophageal-type mucosa.

Final diagnosis

A. Duodenum, biopsy - duodenum with moderate focal crypt hyperplasia and mild focal villous atrophy in keeping with celiac disease with:

i) modified Marsh grade 1.

B. Gastric antrum, biopsy - no pathologic diagnosis.
C. Gastric body, biopsy - no pathologic diagnosis.
D. Esophagus; biopsy - no pathologic diagnosis.

Mild increase of IELs

SMALL BOWEL, BIOPSY:
- SMALL BOWEL MUCOSA WITH MILDLY INCREASED INTRAEPITHELIAL LYMPHOCYTES
  (~30 LYMPHOCYTES/100 ENTEROCYTES) WITHOUT SIGNIFICANT CHANGES OF THE
  VILLOUS ARCHITECTURE, SEE COMMENT.
- NEGATIVE FOR ACTIVE INFLAMMATION.
- NEGATIVE FOR DYSPLASIA.

COMMENT:
The number of intraepithelial lymphocytes (IELs) in celiac disease is typically higher than
40 per 100 enterocytes. A mild increase of IELs is a nonspecific finding. Serology for
celiac disease could be considered, if not done. Clinical correlation is suggested.