Celiac Biopsy Results - Overlaps with Lymphomas?

[FemmeK]

Good morning. I got my biopsy results back from endoscopy and colonscopy. I have been trying to get in touch with the doctor to get clarity on some of the phrases in the pathology report. It says probable celiac but I am nervous about some of this and wondered if any of you had this language in your celiac results. If so, were you also referred for more consideration of certain Lymphomas of the intestine such as MALT Lymphoma? Or did you have this language in your results with still a straight celiac diagnosis? Thanks so much! 

"...focal surface intraepithelial lymphocytosis. The lamina propria is expanded by lymphoplasmacytic and eosinophilic infiltrate. Scattered lymphoepithelial lesions are present."

These "Lesions" are what make me most nervous because when I Google it, all I see are articles about Lymphomas - often secondary to celiac. 

[Scott Adams]

Here's a breakdown of the terms in the biopsy report:

• Focal Surface Intraepithelial Lymphocytosis: This suggests an increased number of lymphocytes (a type of white blood cell) within the surface layer of the intestinal lining (epithelium) in certain areas of the biopsy sample. In celiac disease, intraepithelial lymphocytosis is often observed.
• Lamina Propria Expansion: The lamina propria is a layer of connective tissue just beneath the intestinal epithelium. "Expanded by lymphoplasmacytic and eosinophilic infiltrate" suggests that there is an increased presence of lymphocytes and plasma cells, as well as eosinophils, in this tissue. This can be indicative of inflammation.
• Scattered Lymphoepithelial Lesions: This term indicates the presence of certain cellular changes in the mucosal lining of the intestine. These changes can be associated with celiac disease.

Overall, the biopsy findings you provided appear to be consistent with features often seen in celiac disease, such as intraepithelial lymphocytosis, inflammation in the lamina propria, and lymphoepithelial lesions. However, a definitive diagnosis and appropriate treatment should be determined by a gastroenterologist or healthcare professional who can consider the entire clinical picture, including symptoms, blood test results (such as serology for celiac antibodies), and other relevant information. It's important for the individual to discuss these results with their healthcare provider to get a clear understanding of their condition and develop an appropriate management plan.

[FemmeK]

1 hour ago, Scott Adams said:

Here's a breakdown of the terms in the biopsy report:

• Focal Surface Intraepithelial Lymphocytosis: This suggests an increased number of lymphocytes (a type of white blood cell) within the surface layer of the intestinal lining (epithelium) in certain areas of the biopsy sample. In celiac disease, intraepithelial lymphocytosis is often observed.
• Lamina Propria Expansion: The lamina propria is a layer of connective tissue just beneath the intestinal epithelium. "Expanded by lymphoplasmacytic and eosinophilic infiltrate" suggests that there is an increased presence of lymphocytes and plasma cells, as well as eosinophils, in this tissue. This can be indicative of inflammation.
• Scattered Lymphoepithelial Lesions: This term indicates the presence of certain cellular changes in the mucosal lining of the intestine. These changes can be associated with celiac disease.

Overall, the biopsy findings you provided appear to be consistent with features often seen in celiac disease, such as intraepithelial lymphocytosis, inflammation in the lamina propria, and lymphoepithelial lesions. However, a definitive diagnosis and appropriate treatment should be determined by a gastroenterologist or healthcare professional who can consider the entire clinical picture, including symptoms, blood test results (such as serology for celiac antibodies), and other relevant information. It's important for the individual to discuss these results with their healthcare provider to get a clear understanding of their condition and develop an appropriate management plan.

Thank you SO much, Scott! I so appreciate your time in explaining these items to me! This is very helpful. When I Google some of these things in isolation, the results are skewed toward Lymphoma though I realized that this is not the best way to insure that I know how to interpret. I appreciate your time here. 

[Scott Adams]

This article has some detailed information on how to be 100% gluten-free, so it may be helpful:

 

 

[FemmeK]

Thank you!! This is great.