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Type II refractory sprue, collagenous sprue
70 years
First diagnosis of celiac disease 4 years prior to current biopsy. Negativity for anti-transglutaminase antibodies under strict gluten free diet, but persistent weight loss.oss.
The majority of the intraepithelial lymphocytes are positive for CD3. Blunting of villi. Dense interstitial lymphocytic infiltration. Sub-epithelial collagenous band with loss of epithelial layer (thickness > 30 um) and entrapment of cells. No sign of crypt hyperplasia but focal crypt atrophy. Sparse mitotic activity for celiac disease.
For HE stain see slide ID: 1541 For EvG stain see slide ID: 1542 For CD8 IHC see slide ID: 1544 No proof of monoclonal T-cell receptor rearrangement in the performed PCR.
De Mascarel A, Belleannée G, Stanislas S, Merlio C, Parrens M, Laharie D, Dubus P, Merlio JP.
Mucosal intraepithelial T-lymphocytes in refractory celiac disease: a neoplastic population with a variable CD8 phenotype.
Am J Surg Pathol. 2008 May;32(5):744-51. doi: 10.1097/PAS.0b013e318159b478. PubMed PMID: 18360280.
Link: http://www.ncbi.nlm.nih.gov/pubmed/1836028060280
Joël Gsponer
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