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Biopsy Pathology Report--No Marsh Level


ema2013

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ema2013 Newbie

I have my pathology report, and there is no mention of Marsh level.  Is this normal?  It does say, under final diagnosis, "severe mucosal lesion, consistent with celiac disease".  I thought all reports had to list the Marsh level.  There is a microscopic description on it though.  I'm new to celiac disease and am trying to figure this stuff out.  My GI was no help at all, other than to say "quit eating gluten".  Thanks for listening.


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GottaSki Mentor

Hi there!

 

No, Marsh Scale is rarely mentioned until the biopsies are level Marsh III.  This is because the first two stages can be attributed to things other than Celiac Disease.

 

Does this report mention "lymphcytes", "villi" or "crypts".  Sadly, there are many variations offered by pathology labs which can make it tough to understand their meaning.

 

I don't know your history, but if you have positive blood work, deficient nutrients, familial history of celiac or symptoms associated with celiac it is indeed time to remove all gluten from your world now that your biopsy is complete.

 

Good luck and let us know if you have more questions :)

ema2013 Newbie

Hi there!

 

No, Marsh Scale is rarely mentioned until the biopsies are level Marsh III.  This is because the first two stages can be attributed to things other than Celiac Disease.

 

Does this report mention "lymphcytes", "villi" or "crypts".  Sadly, there are many variations offered by pathology labs which can make it tough to understand their meaning.

 

I don't know your history, but if you have positive blood work, deficient nutrients, familial history of celiac or symptoms associated with celiac it is indeed time to remove all gluten from your world now that your biopsy is complete.

 

Good luck and let us know if you have more questions :)

I've been anemic for years (am 53).  The bloodwork was positive and the GI insisted on a colonoscopy and endoscopy.  The microscopic description on the pathology report says:  "Very few villi are visible, and these are significantly blunted.  For the most part, the biopsies superficially resemble colon.  Surface epithelium and crypt epithelium are remarkable for a noticeable lymphoid infiltrate, but lymphocytes are not present in large numbers.  The lamina propria has increased numbers of lymphocytes, plasma cells, and probably eosinophils, with congestion of superficial capillaries.  Included muscularis mucosae and scant submucosa are unremarkable." 

My GI just said I had celiac and to quit eating gluten.  I guess I'm a little OCD; I would like to try to understand more about what I have.

GottaSki Mentor

I've been anemic for years (am 53).  The bloodwork was positive and the GI insisted on a colonoscopy and endoscopy.  The microscopic description on the pathology report says:  "Very few villi are visible, and these are significantly blunted.  For the most part, the biopsies superficially resemble colon.  Surface epithelium and crypt epithelium are remarkable for a noticeable lymphoid infiltrate, but lymphocytes are not present in large numbers.  The lamina propria has increased numbers of lymphocytes, plasma cells, and probably eosinophils, with congestion of superficial capillaries.  Included muscularis mucosae and scant submucosa are unremarkable." 

My GI just said I had celiac and to quit eating gluten.  I guess I'm a little OCD; I would like to try to understand more about what I have.

 

There is absolutely no doubt, you have celiac disease -- welcome to the club...I'll ask the official greeter to get the super decoder ring in the mail ;)

 

Ok...joking aside -- the description provided from the report is absolutely describing celiac disease.  Why they did not reference the Marsh Scale is interesting.

 

I'm sorry your GI simply said you have celiac and quit eating gluten -- sadly this is far better advice than many doctors out there provide.  You have come to the right place to begin your new gluten-free life.  Let us know if you have any questions.

bartfull Rising Star

Welcome! I think the first thing you should do is go to the coping section here and read the Newbie 101 thread. Be sure to click on all the links provided in the various posts in that thread. Keep a pen and paper handy to jot down any questions that arise, then come back and ask away. :)  

cyclinglady Grand Master

I am 52 and I was anemic. I requested a colonoscopy since all my friends were getting one! GI mentioned celiac and I was shocked. My husband has been gluten free for 13 years and I thought, "What are the odds that both of us have gluten issues?" Blood test mildly positive and my biopsy revealed severe damage. It has been a year and my anemia has resolved. I did fracture a vertebrae doing nothing three months after my celiac disease dx (osteoporosis), so I would recommend a bone scan.

Welcome!

moosemalibu Collaborator

Welcome!

 

Your biopsy results are definitely a Celiac description. Coupled with the blood work and anemia that pretty much screams classic case. My biopsy results were not as clean and straight forward as yours appear.  The blunted villi, smooth appearance and infiltration of eosinophils is what they generally look for as hallmark histology. Definitely check out the newbie threads.


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