具有上皮内淋巴细胞增多的正常绒毛结构：克罗恩病的十二指肠表现
Normal villous architecture with increased intraepithelial lymphocytes: a duodenal manifestation of Crohn disease.
作者信息
Patterson Emily R, Shmidt Eugenia, Oxentenko Amy S, Enders Felicity T, Smyrk Thomas C
机构信息
From the Division of Anatomic Pathology.
Department of Internal Medicine.
出版信息
Am J Clin Pathol. 2015 Mar;143(3):445-50. doi: 10.1309/AJCPBKQND4SHVX9Q.
OBJECTIVES
To assess a possible association between inflammatory bowel disease (IBD) and the histologic finding in duodenal biopsy specimens of increased intraepithelial lymphocytes (IELs) with normal villous architecture.
METHODS
We identified all patients with duodenal biopsy specimens obtained between 2000 and 2010 showing increased IELs and normal architecture. Among the 74 such patients who also had IBD, we characterized the clinical features of IBD and reviewed all available upper gastrointestinal biopsy specimens.
RESULTS
Fifty-eight patients had Crohn disease, 13 had ulcerative colitis, and three had IBD, type unclassified. No duodenal sample with increased IELs had other histologic features of IBD. Among gastric biopsy specimens from 34 patients with Crohn disease, nearly half (16) had focal gastritis.
CONCLUSIONS
We propose that Crohn disease be included in the differential diagnosis for increased IELs with normal villous architecture in duodenal biopsy specimens, particularly when gastric biopsy specimens show focal gastritis.
目的
评估炎症性肠病（IBD）与十二指肠活检标本中上皮内淋巴细胞（IELs）增多且绒毛结构正常的组织学表现之间可能存在的关联。
方法
我们识别出2000年至2010年间获取的所有十二指肠活检标本显示IELs增多且结构正常的患者。在这74例同时患有IBD的患者中，我们对IBD的临床特征进行了描述，并复查了所有可用的上消化道活检标本。
结果
58例患者患有克罗恩病，13例患有溃疡性结肠炎，3例患有未分类的IBD。没有IELs增多的十二指肠样本具有IBD的其他组织学特征。在34例克罗恩病患者的胃活检标本中，近一半（16例）有局灶性胃炎。
结论
我们建议，对于十二指肠活检标本中IELs增多且绒毛结构正常的情况，尤其是当胃活检标本显示局灶性胃炎时，克罗恩病应纳入鉴别诊断。
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