The histopathology of pediatric celiac disease: order must prevail out of chaos.

Abstract:

:The role of histopathology for diagnosing celiac disease (CD) has been recently challenged. However, based in our experience with roughly 4,600 distal duodenal and jejunal biopsies in children it is apparent that appropriate biopsy site, handling, processing, and microscopic evaluation result in a consistent pattern of microscopic changes which allows strong clinical-pathologic correlation. A simple way for establishing the villous/crypt (V/C) ratio is proposed. Normal mucosa displays a V/C ratio of 2.5 or more. Villous atrophy is then graded according to the V/C ratio as follows: Grade 1: 2.5-2; Grade 2: 1-2; Grade 3: 1-0.5, and Grade 4: less than 0.5. The grading should be done in areas of the biopsy where at least 2 to 3 crypts are present in almost its full length. CD disease was consistently associated with villous atrophy grades 3 and 4, which fully recovered or maintained Grade 1 after gluten-free diet. Grade 2 biopsies were rare and related to incomplete gluten-free diet. Patchy lesions were never seen as were patients with normal biopsies later developing mucosal atrophy. Histopathologic evaluation of mucosal biopsies to rule out CD requires adequate biopsy site (distal duodenum or proximal jejunum), and proper handling (oriented material), processing (cutting on edge) and interpretation. The proposed villous atrophy grading may help to adequately compare experiences from different centers as well as to reconcile apparent different findings in separate biopsies. In children histopathology keeps on having a central role for CD diagnosis.

journal_name

Int J Surg Pathol

authors

Drut R,Rúa EC

doi

10.1177/106689690100900401

keywords:

subject

Has Abstract

pub_date

2001-10-01 00:00:00

pages

261-4

issue

4

eissn

1066-8969

issn

1940-2465

journal_volume

9

pub_type

社论
  • IgG4-positive sclerosing cholangitis following autoimmune pancreatitis with deranged CA19.9.

    abstract::Sclerosing cholangitis is an autoimmune condition characterized by lymphocytic infiltration within the biliary epithelium leading to multifocal stricturing of the biliary tree. Primary sclerosing cholangitis (PSC) is the most common type encountered clinically. However, a similar process may occur in conjunction with ...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章

    doi:10.1177/1066896908319777

    authors: Ong SL,Garcea G,Puls F,Richards C,Mulcahy K,Grant A,Dennison AR,Berry DP

    更新日期:2011-02-01 00:00:00

  • A Novel Case of Mammary-Type Myofibroblastoma With Sarcomatous Features.

    abstract::Mammary-type myofibroblastoma (MFB) is a benign spindle cell tumor of the breast and soft tissue characterized by 13q14 alterations leading to loss of Rb-1 protein expression, a feature shared among spindle cell lipoma and cellular angiofibroma. In this article, we present a novel case of MFB arising in the left breas...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章

    doi:10.1177/1066896920947465

    authors: Strait AM,Linos K,Tafe LJ,Muller KE

    更新日期:2020-08-05 00:00:00

  • Papilliferous keratoameloblastoma of mandible: a papillary ameloblastic carcinoma: report of a case with a 6-year follow-up and review of the literature.

    abstract::We report a fourth case of papilliferous keratoameloblastoma, with a 6-year follow-up. A 62-year-old man underwent resection of a right mandibular neoplasm infiltrating bone and soft tissues. Microscopically, there were cysts lined by papillary projections and containing necrotic debris. Cribriform, solid, and tubular...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章,评审

    doi:10.1177/106689690201000210

    authors: Collini P,Zucchini N,Vessecchia G,Guzzo M

    更新日期:2002-04-01 00:00:00

  • Warthin Tumor-Like Mucoepidermoid Carcinoma.

    abstract::Mucoepidermoid carcinoma (MEC) shows a wide morphologic spectrum, including epithelium with oncocytic or squamous metaplastic changes overlying a prominent cystic architecture, as well as tumor-associated lymphoid tissue. We illustrate a case of MEC of the parotid in a 17-year-old female, in which all these features o...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章

    doi:10.1177/1066896917724889

    authors: Heatley N,Harrington KJ,Thway K

    更新日期:2018-02-01 00:00:00

  • Metachronous Uterine Endometrioid Adenocarcinoma and Peritoneal Mesothelioma in Lynch Syndrome: A Case Report.

    abstract::Lynch syndrome is a hereditary disease with germline mutation in a DNA mismatch repair gene, most often presenting with colorectal and/or endometrial carcinomas; however, the spectrum of Lynch syndrome-associated tumors is expanding. In this article, we report a case of a primary peritoneal epithelioid mesothelioma th...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章

    doi:10.1177/1066896916680745

    authors: Lu Y,Milchgrub S,Khatri G,Gopal P

    更新日期:2017-05-01 00:00:00

  • MUM-1 expression differentiates tumors in the PEComa family from clear cell sarcoma and melanoma.

    abstract::PEComas are mesenchymal neoplasms composed of perivascular epithelioid cells (PEC) and include a spectrum of tumors. PEComas and malignant melanoma share common morphological, immunohistochemical, and ultrastructural features, such as epithelioid cell morphology and melanocytic immunophenotype. Melanocytic markers com...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章

    doi:10.1177/1066896911418204

    authors: Ferenczi K,Lastra RR,Farkas T,Elenitsas R,Xu X,Roberts S,Brooks JS,Zhang PJ

    更新日期:2012-02-01 00:00:00

  • Topography of Protein Kinase C βII in Benign and Malignant Melanocytic Lesions.

    abstract:BACKGROUND:Protein kinase C βII promotes melanogenesis and affects proliferation of melanocytic cells but is frequently absent or decreased in melanoma cells in vitro. OBJECTIVE:To investigate PKC-βII expression and spatial distribution within a lesion in various benign and malignant melanocytic proliferations. METHO...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章

    doi:10.1177/1066896917706026

    authors: Krasagakis K,Tsentelierou E,Chlouverakis G,Stathopoulos EN

    更新日期:2017-09-01 00:00:00

  • Acute Appendicitis and Pneumatosis in a Duplicated Appendix With Schistosoma Remnants.

    abstract::Appendiceal pneumatosis is rare, reported either in the context of acute appendicitis or enterocolitis. Here, we report the case of an elderly adult in whom the acute appendicitis was associated with pneumatosis and occurred in the context of a malformed appendix with pathogenic organism remnants. A 72-year-old man pr...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章

    doi:10.1177/1066896915597750

    authors: Handra-Luca A,Bisseret D,Dragoescu E

    更新日期:2016-02-01 00:00:00

  • A Practical Approach to Investigating Cross-Contaminants in the Anatomical Pathology Laboratory.

    abstract::Tissue contaminants in anatomical pathology are not uncommon. While issues related to the presence of extraneous tissue on glass slides are often easily resolved, this is not always the case and several factors may contribute to diagnostic difficulty. Because of this, familiarity with the different steps involved in h...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章

    doi:10.1177/1066896920913110

    authors: Hodgson AJ,Shang YM,Boulianne P,Downes MR,Hwang D,Slodkowska E

    更新日期:2020-10-01 00:00:00

  • The Helpful Role of CD10 and Hormonal Receptors Co-Expression in the Histologic Diagnosis of Catamenial Pneumothorax.

    abstract::The histology in cases of primary spontaneous pneumothorax is generally nonspecific, but a careful examination, taking into account clinical data, may reveal subtle tissue alterations leading to a specific diagnosis in cases that might otherwise be taken as primary and spontaneous. In this article, we describe 3 cases...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章

    doi:10.1177/1066896919846386

    authors: Mataca E,Rossi G,Colby TV

    更新日期:2019-09-01 00:00:00

  • Isolated Gallbladder Intramucosal Metastatic Melanoma With Features Mimicking Lymphoepithelial Carcinoma.

    abstract::Malignant melanoma has a variety of morphologic patterns and can metastasize and mimic any type of neoplastic process creating significant diagnostic difficulty. When metastasis to the gastrointestinal system is identified, it is most commonly associated with widely metastatic disease. We report a rare case of isolate...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章

    doi:10.1177/1066896915588932

    authors: Lo AA,Peevey J,Lo EC,Guitart J,Rao MS,Yang GY

    更新日期:2015-08-01 00:00:00

  • Papillary thyroid carcinoma of the thyroglossal duct cyst: comparative cytohistologic and immunochemical study of 2 new cases and review of the literature.

    abstract::We report a cytohistologic and immunohistochemical study of 2 cases of papillary thyroid carcinoma occurring in a thyroglossal duct cyst. The patients were a 21-year-old woman and a 48-year-old man. Needle aspiration cytology smears were consistent with papillary thyroid carcinoma. The Sistrunk procedure was done. Pap...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章

    doi:10.1177/106689690100900114

    authors: Falconieri G,Della Libera D,Zanella M

    更新日期:2001-01-01 00:00:00

  • Metaplastic thymoma: report of an unusual thymic epithelial neoplasm arising in the wall of a thymic cyst.

    abstract::In this report, a case of metaplastic thymoma arising in a thymic cyst wall is discussed. The patient was a 61-year-old male whose chief complaint was sweating and chest pain. Imaging study revealed a mediastinal mass with right hemithoracic extension. He underwent surgical resection of the mass and remnants of the th...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章

    doi:10.1177/1066896908315754

    authors: Poorabdollah M,Mehdizadeh E,Mohammadi F,Sabeti S

    更新日期:2009-02-01 00:00:00

  • Upper Gastrointestinal Langerhans Cell Histiocytosis: A Report of 2 Adult Cases and a Literature Review.

    abstract::Langerhans cell histiocytosis (LCH) with primary involvement of the upper gastrointestinal (GI) tract is rare. We report 2 adult cases of localized LCH in the upper-GI tract, including the second reported adult case of esophageal LCH and review 11 previously reported cases. Case 1 involved the esophagus of a 61-year-o...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章

    doi:10.1177/1066896920964566

    authors: Matsuoka Y,Iemura Y,Fujimoto M,Shibuya S,Yamada A,Fujii S,Kusaka T,Shindo T,Minamiguchi S,Haga H

    更新日期:2020-10-09 00:00:00

  • Primary vaginal Ewing sarcoma: case report and review of the literature.

    abstract::Ewing sarcoma (ES) and primitive neuroectodermal tumor (PNET) are round-cell sarcomas with varying degrees of neuroectodermal differentiation; they are considered members of the same family of tumors based on their common genetic profile. ES/PNET are very infrequent in the female genital tract, the vagina being the ra...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章,评审

    doi:10.1177/1066896911424898

    authors: Bancalari E,de Álava E,Tardío JC

    更新日期:2012-06-01 00:00:00

  • Superficial CD34-Positive Fibroblastic Tumor.

    abstract::Superficial CD34-positive fibroblastic tumor (SCPFT) is a recently described entity that, despite significant pleomorphism, carries a good prognosis. We briefly describe this tumor and its principal differential diagnoses. Recognition of SCPFTs, including the clinical context in which they arise, is important to avoid...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章

    doi:10.1177/1066896920938133

    authors: Foot O,Hallin M,Bagué S,Jones RL,Thway K

    更新日期:2020-12-01 00:00:00

  • Primary CNS Nonamyloidogenic Light Chain Deposition Disease: Case Report and Brief Review.

    abstract::The true incidence of light chain deposition disease (LCDD) restricted to the central nervous system (CNS) is unknown. To our knowledge only 7 cases of LCDD restricted to the brain have been previously reported. We herein describe an unusual example. A 44-year-old man presented with a history of ischemic retinopathy i...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章,评审

    doi:10.1177/1066896917717338

    authors: Mercado JJ,Markert JM,Meador W,Chapman P,Perry A,Hackney JR

    更新日期:2017-12-01 00:00:00

  • Application of CARD-ISH for Assessment of Numerical Chromosome Aberrations in Interphase Nuclei of Human Tumor Cells.

    abstract::In this study based on the study of a centromeric DNA probe specific for chromosome 8 the authors standardized a method for the enzymatic detection of specific chromosome copy numbers on interphase nuclei from tumor tissue samples. Since the in situ hybridization (ISH) of chromosome 8 specific probe was revealed with ...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章

    doi:10.1177/106689690000800307

    authors: Buonamici L,Serra M,Losi L,Eusebi V

    更新日期:2000-07-01 00:00:00

  • Mucinous and Signet Ring Cell Differentiation Affect Patterns of Metastasis in Colorectal Carcinoma and Influence Survival.

    abstract::Peritoneal metastasis in colorectal carcinoma is associated with a dismal prognosis; however, features that correlate with patterns of metastatic spread are not well characterized. We analyzed the clinicopathologic and molecular features of 166 patients with colorectal carcinomas stratified by metastases to the perito...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章

    doi:10.1177/1066896916664990

    authors: Kermanshahi TR,Magge D,Choudry H,Ramalingam L,Zhu B,Pingpank J,Ahrendt S,Holtzman M,Zeh H,Bartlett D,Zureikat A,Pai RK

    更新日期:2017-04-01 00:00:00

  • Benign fibro-osseous lesions of the jaws: a study of 127 Chinese patients and review of the literature.

    abstract::The aim of this study is to analyze all the cases of benign fibro-osseous lesions treated at School and Hospital of Stomatology, Wuhan University, to compare the results obtained in this study with those previously documented by other authors. The 127 cases diagnosed as a fibro-osseous lesion were retrieved, and infor...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章,评审

    doi:10.1177/1066896908318744

    authors: Alsharif MJ,Sun ZJ,Chen XM,Wang SP,Zhao YF

    更新日期:2009-04-01 00:00:00

  • Spitz Tumors: Comparison of Histological Features in Relationship to Immunohistochemical Staining for ALK and NTRK1.

    abstract::Spitz tumors are a group of melanocytic neoplasms with distinct morphological features that tend to affect young individuals. Distinguishing benign from malignant Spitz tumors can be challenging, but cytogenetic and molecular tests have contributed to improvements in diagnostic accuracy. Spitz tumors harbor diverse ge...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章

    doi:10.1177/1066896916630375

    authors: Kiuru M,Jungbluth A,Kutzner H,Wiesner T,Busam KJ

    更新日期:2016-05-01 00:00:00

  • Adenocarcinoma-Papillary Cystic Pattern Arising in a Mixed Squamous and Glandular Papilloma of the Lung.

    abstract::Mixed squamous and glandular papilloma (mixed papilloma) of the lung has been reported in fewer than 25 cases in the English literature. Although it is known as a benign tumor, malignant transformation has been reported. Papillary cystic carcinoma is characterized by papillary and cystic growth patterns and has been r...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章

    doi:10.1177/1066896920908330

    authors: An AR,Park SY,Kim JH,Chae KJ,Chung MJ

    更新日期:2020-09-01 00:00:00

  • Displaced epithelium after liposuction for gynecomastia.

    abstract::The authors describe the case of a 36-year-old man with gynecomastia who was previously treated with liposuction of the breast for cosmetic purposes. Histologic examination of a subsequent excisional biopsy revealed nests of displaced epithelial cells in adipose tissue. Epithelial cell displacement is a well-known ris...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章

    doi:10.1177/1066896910362990

    authors: McLaughlin CS,Petrey C,Grant S,Ransdell JS,Reynolds C

    更新日期:2011-08-01 00:00:00

  • Dedifferentiated Liposarcoma Mimicking a Primary Colon Mass.

    abstract::Dedifferentiated liposarcoma is typically a nonlipogenic high-grade sarcoma that arises from well-differentiated liposarcoma. It most commonly presents as a large mass in the retroperitoneum. Significant involvement of the gastrointestinal tract by dedifferentiated liposarcoma is uncommon. We present a unique case of ...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章

    doi:10.1177/1066896917731517

    authors: Hollowoa B,Lamps LW,Mizell JS,English GW 3rd,Bridge JA,Ram R,Gardner JM

    更新日期:2018-04-01 00:00:00

  • Clinicopathologic analysis of 4 perivascular epithelioid cell tumors (PEComas) of the gastrointestinal tract.

    abstract::This study describes the clinical, histologic, and immunohistochemical features of four cases of GI PEComa. The size of the tumors ranged from 3.5 to 6.0cm in diameter, and all were located in wall of the large bowel. Microscopically, the tumors were characterized by an epithelioid arrangement of tumor cells, which ha...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章

    doi:10.1177/1066896908330481

    authors: Shi HY,Wei LX,Sun L,Guo AT

    更新日期:2010-08-01 00:00:00

  • Mucosal Schwann Cell Hamartoma of the Rectosigmoid Junction: A Rare Lesion Mimicking Mucosal Prolapse Syndrome and Other Neural Lesions.

    abstract::In this article, we report the case of a 40-year-old woman with a sessile polyp of the rectosigmoid junction that underwent endoscopic resection. The resected specimen showed spindle cell proliferation with eosinophilic cytoplasm between mucosal crypts, mimicking mucosal prolapse syndrome. However, these were immunohi...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章

    doi:10.1177/1066896918818897

    authors: Hashimoto H,Usui G,Sakai E,Ohata K,Morikawa T

    更新日期:2019-08-01 00:00:00

  • Primary Mixed Adenoneuroendocrine Carcinoma of the Gallbladder in a 55-Year-Old Female Patient: A Case Report and Review of the Literature.

    abstract::Mixed adenoneuroendocrine carcinomas (MANECs) of the biliary tract are rare tumors, and to date only a few cases arising in the gallbladder have been reported. Their histogenesis is a matter of debate, since the biliary tract normally lacks neuroendocrine cells. However, the immunohistochemical identification of nonne...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章,评审

    doi:10.1177/1066896915580433

    authors: Acosta AM,Hamedani FS,Kajdacsy-Balla A,Wiley EL

    更新日期:2015-08-01 00:00:00

  • Hepatic rosai-dorfman disease with coincidental lymphoma: report of a case.

    abstract::Rosai-Dorfman disease (RDD; sinus histiocytosis with massive lymphoadenopathy) is a rare, usually nodal self-limited disease. Sometimes nodal disease is coupled with extranodal localizations, in which case the disease can follow a protracted clinical course characterized by remissions and relapses and, exceptionally, ...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章

    doi:10.1177/1066896908329590

    authors: Di Tommaso L,Rahal D,Bossi P,Roncalli M

    更新日期:2010-12-01 00:00:00

  • Mixed Intraepithelial Neoplasia-Well-Differentiated Neuroendocrine Tumor of the Gallbladder: A Hitherto Unreported Combination.

    abstract::Adenocarcinomas and noninvasive intraepithelial neoplasms (either polypoid or flat) are the most common gallbladder tumors; however, neuroendocrine neoplasms (NENs) can also occur. The majority of NENs are represented by neuroendocrine carcinomas (NECs), while neuroendocrine tumors (NETs) are extremely rare in this lo...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章

    doi:10.1177/1066896920986987

    authors: Kővári B,Turkevi-Nagy S,Lauwers GY,Jiang K

    更新日期:2021-01-09 00:00:00

  • Atypical adenomatous hyperplasia (adenosis) of the prostate: DNA ploidy analysis and immunophenotype.

    abstract::Atypical adenomatous hyperplasia (AAH) of the prostate is a microscopic proliferation of small acini that may be mistaken for adenocarcinoma. Although some data suggest that AAH is associated with adenocarcinoma arising in the transition zone, the clinical significance of this lesion is uncertain. Therefore we studied...

    journal_title:International journal of surgical pathology

    pub_type: 杂志文章

    doi:10.1177/106689690501300207

    authors: Lopez-Beltran A,Qian J,Montironi R,Luque RJ,Bostwick DG

    更新日期:2005-04-01 00:00:00