Practical Approach to the Flattened Duodenal Biopsy

Thomas Christopher Smyrk

Research output: Contribution to journalArticle

2 Citations (Scopus)

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.

Original languageEnglish (US)
JournalSurgical Pathology Clinics
DOIs
StateAccepted/In press - 2017

Fingerprint

Celiac Disease
Lymphocytosis
Atrophy
Biopsy
Collagenous Sprue
Tropical Sprue
Common Variable Immunodeficiency
Wounds and Injuries
Non-Steroidal Anti-Inflammatory Agents
Gastritis
Plasma Cells
Granuloma
Helicobacter pylori
Neutrophils
Differential Diagnosis
Lymphocytes
Pharmaceutical Preparations

Keywords

  • Celiac disease
  • Collagenous sprue
  • Common variable immunodeficiency
  • Intraepithelial lymphocytes
  • Tropical sprue

ASJC Scopus subject areas

  • Surgery
  • Pathology and Forensic Medicine

Cite this

Practical Approach to the Flattened Duodenal Biopsy. / Smyrk, Thomas Christopher.

In: Surgical Pathology Clinics, 2017.

Research output: Contribution to journalArticle

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