Gluten sensitive enteropathy and other causes of small intestinal lymphocytosis.
Recent studies on gluten sensitive enteropathy (GSE) have heightened the pathologist's awareness of intraepithelial lymphocytes in duodenal biopsies. Mild histologic forms of GSE are now recognized with increased IELs as the only histologic change. In this review, both the classic morphology and "minimal deviation" GSE are discussed in detail, with special emphasis on the differential diagnosis and how to avoid overdiagnosing this condition. The Marsh-Oberhuber classification is described and contrasted with a more practical diagnostic terminology that is recommended for use in pathology reports. Other important conditions associated with duodenal lymphocytosis, such as refractory sprue, autoimmune enteropathy, and Helicobacter pylori-associated duodenitis, are also presented.
Robert
Marie E
ME
Program in Gastrointestinal Pathology, Yale University School of Medicine, New Haven, Connecticut 06520-8023, USA. marie.robert@yale.edu
D001706:Biopsy; D002446:Celiac Disease / Q000145:classification* / Q000175:diagnosis* / Q000209:etiology; D003937:Diagnosis, Differential; D006801:Humans; D007421:Intestine, Small / Q000473:pathology*; D008218:Lymphocytosis / Q000175:diagnosis*