Normal villous architecture with increased intraepithelial lymphocytes: A duodenal manifestation of Crohn disease

Emily R. Patterson, Eugenia Shmidt, Amy S. Oxentenko, Felicity T. Enders, Thomas C. Smyrk

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Objectives: To assess a possible association between inflammatory bowel disease (IBD) and the histologic finding in duodenal biopsy specimens of increased intraepithelial lymphocytes (IELs) with normal villous architecture. Methods: We identified all patients with duodenal biopsy specimens obtained between 2000 and 2010 showing increased IELs and normal architecture. Among the 74 such patients who also had IBD, we characterized the clinical features of IBD and reviewed all available upper gastrointestinal biopsy specimens. Results: Fifty-eight patients had Crohn disease, 13 had ulcerative colitis, and three had IBD, type unclassified. No duodenal sample with increased IELs had other histologic features of IBD. Among gastric biopsy specimens from 34 patients with Crohn disease, nearly half (16) had focal gastritis. Conclusions: We propose that Crohn disease be included in the differential diagnosis for increased IELs with normal villous architecture in duodenal biopsy specimens, particularly when gastric biopsy specimens show focal gastritis.

Original languageEnglish (US)
Pages (from-to)445-450
Number of pages6
JournalAmerican journal of clinical pathology
Volume143
Issue number3
DOIs
StatePublished - Mar 2015

Keywords

  • Crohn disease
  • Duodenal intraepithelial lymphocytes
  • Etiology

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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