Oberhuber G
Department of Clinical Pathology, University of Vienna, Medical School, Austria.
Biomed Pharmacother. 2000 Aug;54(7):368-72. doi: 10.1016/S0753-3322(01)80003-2.
The diagnosis of celiac disease (CD) is based upon histologic findings in duodenal or jejunal biopsies. In the past few years it has turned out that the development of CD lesion in the small bowel is a dynamic process which may present in various histologic forms. At one end of the spectrum is a mucosa with normal architecture and an increase in intraepithelial lymphocytes (IEL), at the other end is the classical flat mucosa. Histologic features supporting the diagnosis of CD are architectural changes of the villi and/or crypts, an increase in lamina propria cell density and an increase in IEL counts. For diagnostic purposes and for monitoring CD patients an exact histologic classification of the histologic findings has to be given. This has become possible by using a modified Marsh classification. In the present paper the histologic presentation of CD is presented as well as the modified Marsh classification.
乳糜泻（CD）的诊断基于十二指肠或空肠活检的组织学发现。在过去几年中发现，小肠中CD病变的发展是一个动态过程，可能呈现出各种组织学形式。在这个范围的一端是具有正常结构且上皮内淋巴细胞（IEL）增加的黏膜，另一端是典型的扁平黏膜。支持CD诊断的组织学特征是绒毛和/或隐窝的结构改变、固有层细胞密度增加以及IEL计数增加。为了诊断目的和监测CD患者，必须对组织学发现进行精确的组织学分类。通过使用改良的马什分类法，这已成为可能。本文介绍了CD的组织学表现以及改良的马什分类法。
