Get email alerts Get Celiac.com E-mail Alerts  




Celiac.com Sponsor:
Celiac.com Sponsor:




Ads by Google:






   Get email alerts  Subscribe to FREE Celiac.com email alerts

Pathologist Report - Help Needed!
0

6 posts in this topic

Want to clarify - diagnosed myself a month ago after negative blood tests and negative biopsy as NCGI and have been gluten free since late December.

Went to the doctor two days ago and was pleasantly surprised. Apparently it is just her nurse who is a moron...I did find it funny that the nurse wanted as little to do with me as possible after I excoriated her on the phone.

The doctor on the other hand, when I told her I was still having problems she said that I might easily be gluten intolerant (which, duh, but from what I have read on here, she seems to be one of the few doctors who acknowledge it!) and given the amount of inflammation I showed I should give up dairy for awhile. I was just very happy to hear my doctor parrot what I have been reading on here! I have also been doing my food diary all wrong - only recording major reactions and not minor ones, whoops!

Anyway, I asked her for the pathologist's report and she gave it to me. Shorter than I expected (2 pages), but shockingly some things were done that I did not expect (they DID test for eosinophils, which were not present).

Here it is, in most of its entirety:

Clinical impression: Abnormal mucosa in duodenum; normal mucosa entire stomach; erythematous esophagus.

Gross description: Received in zinc-formalin are six fragments of red-tan soft tissue measuring 0.9 cm x 0.6 cm x 0.2 cm in aggregate.

Received in zinc-formalin are two fragments of red-tan soft tissue measuring 0.4 cm x 0.3 cm x 0.2 cm in aggregate.

Received in formalin are two fragments of soft tissue measuring 0.3 cm x 0.3 cm x 0.1 cm in aggregate.

Miscroscopic description:

Small bowel mucosa with foveolar metaplasia and Brunner gland hyperplasia. Giardia and other parasites not identified.

Foveolar cell hyperplasia, edema of lamina propria and minimal inflammation. No evidence of intestinal metaplasia, malignancy or dysplasia. H.pylori not present.

Esophageal mucosa with basal layer hyperplasia and elongation of esophageal papillae. Eosinophils are not present. There is no columnar mucosa present.

Final diagnosis;

Duodenum, Biopsy with Cold Forceps:

Chronic duodenitis with focal foveolar metaplasia and Brunner gland hyperplasia.

No evidence of celiac sprue.

Giardia not identified.

Stomach, biopsy with cold forceps:

Reactive (erosive) gastropathy

Silver stain negative for H.pylori

Distal esophagus, Biopsy with cold forceps

Hyperplastic squamous mucosa most consistent with chronic reflux esophagitis.

There are no eosinophils present.

No evidence of Barrett's esophagus; no glandular mucosa present.

Phew!! Anyone able to decipher the medical speak for me?

Thanks!

0

Share this post


Link to post
Share on other sites


Ads by Google:

Here it is, in most of its entirety:

Clinical impression: Abnormal mucosa in duodenum; normal mucosa entire stomach; erythematous esophagus.

Gross description: Received in zinc-formalin...............................

..................... able to decipher the medical speak for me?

Firstly, you have irritation of the duodenum and esophagus. What did the Doc Rx'ed? Avoid foods that cause these issues.

Secondly, zinc- formalin (ie: formaldhyde) is a perservative. 10 biopsies taken at various places. Size of each tissue sample, so indicated.

Hope this helps for starters.

0

Share this post


Link to post
Share on other sites

Firstly, you have irritation of the duodenum and esophagus. What did the Doc Rx'ed? Avoid foods that cause these issues.

Secondly, zinc- formalin (ie: formaldhyde) is a perservative. 10 biopsies taken at various places. Size of each tissue sample, so indicated.

Hope this helps for starters.

Thanks, Opa. Formally, I was diagnosed with gastritis, esophagitis, and duodenitis...so I knew about the inflammation in all of those places.

What I really wanted more information about were the words mucosa, hyperplasia and those types of medical lingo. Since I am not a doctor I don't know what those things mean in the context of my esophagus, duodenum and stomach.

Additionally, I wasn't sure if the sizes of the biopsies taken were important or just something usually noted during the biopsy.

0

Share this post


Link to post
Share on other sites

The proper way for a pathologist to start his report is to describe the samples he received, as in the number, their size, their color, their appearance, and where they were labelled as being taken from.

He then details what he sees (or doesn't see) under the microscope.

If you see words you don't understand it often helps to google into an online dictionary to find out what they mean. For example, I googled mucosa, hyperplasia and metaplasia for you, with these results:

"Mucosa:

A mucous tissue lining various tubular structures consisting of epithelium, lamina propria, and, in the digestive tract, a layer of smooth muscle (muscularis mucosae).

hyperplasia - abnormal increase in number of cells

metaplasia - Abnormal transformation of an adult, fully differentiated tissue of one kind into a differentiated tissue of another kind; an acquired condition, in contrast to heteroplasia."

Even the answers may pose more questions than they answer for you. :)

0

Share this post


Link to post
Share on other sites

sounds like the Brunner's gland thing is not normally any problem. This linked case is an unusual one, but the article does describe the Brunner's Gland hyperplasisa.

http://www.ncbi.nlm....les/PMC2526515/

0

Share this post


Link to post
Share on other sites




sounds liek the Brunner's gland thing is not normally any problem. This linked case is an unusual one, bt the article does describe the Brunner's gland hyperplasisa.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2526515/

Yes, the Brunner's gland hyperplasia was the most glaring thing I saw. I looked it up and saw it was a benign tumor in the duodenum - which didn't really worry me just confused me that my doctor wouldn't tell me that.

And yes, mushroom, I agree, the definitions of those words do tend to lead to more questions than answers, haha.

0

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!


Register a new account

Sign in

Already have an account? Sign in here.


Sign In Now
0

  • Forum Statistics

    • Total Topics
      103,884
    • Total Posts
      919,475
  • Topics

  • Posts

    • I'm actually scared to go to the doctor and could use some advice
      Hi Elle......do you think you would have better luck obtaining a full Celiac panel from your GP or a gastro doc?  You really need to be tested for Celiac because of all your symptoms.  Many other people probably thought they were dying of some horrible disease because they had so many symptoms that docs ignored.  Very common problem for us.  Plus, your Mom has had "IBS" all her life.  I should add that IBS is not a diagnosis.  No one needs to be told their bowel is irritated......they already know that.  This is where the medical establishment, no matter where you live in this world, fail us.  They need to find the root cause and there always is one.  You also do not need to have any gastro issues to be a Celiac but you do have some, along with all your symptoms mentioned.  Anxiety is a huge problem with Celiac Disease and for many, it goes away just fine on the gluten-free diet, without need of meds...which should always be a last resort measure.  I have never had an anxiety problem in my entire life until after I was diagnosed with Celiac.  I may have had it but with all the other numerous symptoms I had, the anxiety may have gotten buried somewhere.  But guess what? On the extremely rare occasion when I am glutened or cc'd, I get major anxiety for about 4 days and then its gone. B12 is a water soluble vitamin so whatever you don't use, it exits the body in your urine.  It is pretty damn hard to overdose on the stuff.  I take a B vitamin everyday, very high quality ones and my B12 is usually in the high 600 range.  Optimally, it should be between 650-800 so yours was abysmal pre-supplementation.  Absorption can also be affected by PPI's.  You did notice improvement with the tingling sensation and fatigue once your levels were way up so take notice of that. My biggest advice is to get your mother and you tested for celiac, with a FULL PANEL. Then you'll have to wait and see what that shows. You could always trial a gluten-free diet if all testing is complete and the results were either negative or inconclusive. That sometimes happens with people, especially if they have Celiac's other cousin......non-celiac gluten intolerance.  This would be the best route to go with regards to your anxiety, unless it becomes disabling and you need meds, short term. Make sure you tell them that anxiety is a HUGE symptom of Celiac and it is not normal for younger people to have extreme anxiety like that, for no reason. Good luck to you and please call and make the appointment. I understand your fear....I hate doctors and it's pure mistrust. But sometimes you have to address a problem head on.    
    • newbie diagnosed mom - testing 8 yr old now
      good to know. I am not going for a biopsy. I do not have health insurance, i know i know please no political comments. My children do. My husband and I don't right now. If we lived in another state, we would have coverage. I just made an appt to do a full blood panel for my daughter this week. I would rather find some confirmation for her through a blood test, i feel a scope is too invasive for a child. 
    • Did Jennifer Esposito Leave Town Amid $43 Million Gluten-Free Bakery Lawsuit?
      With a major lawsuit pending, recent reports put the former "Blue Bloods" star in Denmark. View the full article
    • I'm actually scared to go to the doctor and could use some advice
      Well, if I were you, I would go see your doctor and talk to him/her about all this.  Tell your doctor about your anxiety. When I finally did, my doctor prescribed a low dose of an anti-anxiety med and it has made a world of difference in my life.   About the whole thing with the B12 and the weird symptoms . Keep taking the B12 in the meantime to see if that helps again. But talk about it anyway.  If you want a celiac test, ask for the panel to be done. Your doctor may or may not want to send you to a GI for that. Remind him your mom is being tested. You do not have to wait for her results.  Work with your doctor if possible and if not, maybe find a doctor you can work with. If all you end up needing is b12, that's a good thing. If you end up needing more help, starting with your doctor and a heart to heart Talk will have you going in the right direction.
    • gluten free, oat free, egg free breakfast ideas needed for 6 year old
      If she misses the hot cereal then try quinoa or amaranth as an alternative to oatmeal
  • Upcoming Events

  • Blog Entries

  • Recent Status Updates

    • Jmg  »  admin

      Hello Admin!
      I don't know whether this is of interest to post on your articles feed:
      http://pratt.duke.edu/about/news/window-guts-brain
      Kind Regards,
      Matt
      · 2 replies
    • celiac sharon  »  cyclinglady

      Hello cycling lady, have you noticed my picture is showing up as you?  Have no idea why but it's rather disconcerting to see my picture and your words 😉  Do you know how to fix it?  You seem to have far more experience with this board than I do
      · 1 reply
    • Larry Gessner  »  cyclinglady

      Hi There, I don't know if there is a place for videos in the forum. I just watched "The Truth About Gluten" I think it is a good video. I would like to share it somewhere but don't know where it should go. Any help would be greatly appreciated.
      Here is the link if you have never watched it.
      https://youtu.be/IU6jVEwpjnE Thank You,
      Larry
      · 2 replies
  • Who's Online (See full list)

  • Member Statistics

    • Total Members
      60,928
    • Most Online
      1,763

    Newest Member
    Timea
    Joined