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3 Year Followup - Biopsy Results
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3 posts in this topic

Hi everyone,

I just recently had a 3 year followup scope due to multiple nutritional deficiencies and recent weight loss. Here are my results below. My 2 year followup showed very minor villous abnormalities and only plasma cells in the lamina propria. I am wondering if anybody knows what "foci of neutrophils" means? Or any other experiences are appreciated. THanks a lot!

Preoperative Diagnosis:

- Recently tTG-IGA spiked to beyond 200+ levels

- Rule out refractory sprue and lymphoma

Postoperative Diagnosis:

1. Small bowel appearance classic for celiac disease, refractory to years of gluten restriction.

2. Small bowel folds show evidence of complete flattening of the villi, multiple mucosal ridges, endoscopic scalloping, mosaic appearance and classic cracked cement appearance. No frank ulceration or friability or mucosal lesions frankly seen. No luminal narrowing or dilated areas. The pyloric channel is clear.

Pathology Report:

1. Villous abnormality, acute and chronic inflammatory cells in the lamina propria and increased IEL's found

Comments:

Sections show villous abnormality varying from slender to blunted to completely flattened villi. These are increased inflammatory cells in the lamina propria composed of lymphocytes, plasma and foci of neutrophils. IEL's are also increased and present. These finds are non-specific and consistant with Celiac Disease. No evidence of lymphoprofilerative disorder is seen. Slides reviewed at intra-departmental rounds.

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Hi everyone,

I just recently had a 3 year followup scope due to multiple nutritional deficiencies and recent weight loss. Here are my results below. My 2 year followup showed very minor villous abnormalities and only plasma cells in the lamina propria. I am wondering if anybody knows what "foci of neutrophils" means? Or any other experiences are appreciated. THanks a lot!

Preoperative Diagnosis:

- Recently tTG-IGA spiked to beyond 200+ levels

- Rule out refractory sprue and lymphoma

Postoperative Diagnosis:

1. Small bowel appearance classic for celiac disease, refractory to years of gluten restriction.

2. Small bowel folds show evidence of complete flattening of the villi, multiple mucosal ridges, endoscopic scalloping, mosaic appearance and classic cracked cement appearance. No frank ulceration or friability or mucosal lesions frankly seen. No luminal narrowing or dilated areas. The pyloric channel is clear.

Pathology Report:

1. Villous abnormality, acute and chronic inflammatory cells in the lamina propria and increased IEL's found

Comments:

Sections show villous abnormality varying from slender to blunted to completely flattened villi. These are increased inflammatory cells in the lamina propria composed of lymphocytes, plasma and foci of neutrophils. IEL's are also increased and present. These finds are non-specific and consistant with Celiac Disease. No evidence of lymphoprofilerative disorder is seen. Slides reviewed at intra-departmental rounds.

Hello,

A foci of neutrophils means There was a small focus of neutrophils. Neutrophils are a type of white blood cells that contain many digestive enzymes and are usually present in the initial response to an infection. (looks like my immunology class is starting to pay off!)

I hope that helped a little bit.

Jessica

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IELs are intraepithelial lymphocytes.

A wide variety of immunologic stimuli can elevate intraepithelial lymphocyte numbers. Among the other common associations (besides gluten/active celiac) are enteric infection, autoimmune disease, use of drugs like NSAIDs, and gastric Helicobacter infection. (h pylori)

Maybe you have an infection of some kind? Having villous atrophy after 3 years gluten-free can mean something other than you have refractory sprue, but your doctor should tell you what's going on. It says "These findings are non-specific," but....what did the doctor say??

You shouldn't have to try and interpret this report yourself, hon.

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