Practical Approach to the Flattened Duodenal Biopsy |
| |
| Institution: | 1. Steven & Alexandra Cohen Children''s Medical Center of New York, Northwell Health System, Division of Gastroenterology & Nutrition, New York, United States;2. The Children’s Hospital of Philadelphia, Division of Pediatric Gastroenterology, Hepatology, & Nutrition, Philadelphia, PA, United States;3. The Pediatric Gastroenterology and Hepatology Unit, Department of Pediatrics, University Hospitals of Geneva, Switzerland;4. The Children''s Hospital of Philadelphia, Department of Pathology and Laboratory Medicine, Philadelphia, PA, United States;5. Cardinal Health, Dallas, TX, United States;1. Department of Pathology, Radboud University Medical Centre, Postbox 9101, Nijmegen 6500 HB, The Netherlands;2. Department of Pathology, Centro Hospitalar de São João, Porto, Portugal;3. Department of Pathology, Faculty of Medicine of the University of Porto (FMUP), Alameda Professor Hernâni Monteiro, Porto 4200-319, Portugal;4. Institute of Molecular Pathology and Immunology of the University of Porto (Ipatimup), Rua Júlio Amaral de Carvalho, 45, Porto 4200-135, Portugal;5. Institute for Research Innovation in Health (i3S), Rua Júlio Amaral de Carvalho, 45, Porto 4200-135, Portugal |
| |
| Abstract: | Celiac disease features duodenal intraepithelial lymphocytosis with or without villous atrophy. Lymphocytosis without villous atrophy will be proven to represent celiac disease in 10% to 20% of cases. The differential diagnosis is broad: Helicobacter pylori gastritis, NSAID injury and bacterial overgrowth are considerations. Lymphocytosis with villous atrophy is very likely to be celiac disease, but there are mimics to consider, including collagenous sprue, tropical sprue, drug injury, and common variable immunodeficiency. Histologic clues to a diagnosis other than celiac disease include paucity of plasma cells, excess of neutrophils, granulomas, and relative paucity of intraepithelial lymphocytes. |
| |
| Keywords: | Celiac disease Intraepithelial lymphocytes Collagenous sprue Tropical sprue Common variable immunodeficiency |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
