140b - Pathology of Small Intestine Disorders Flashcards
What SI pathology is shown in this biopsy?
What extra-GI findings may be present?
What is the key to long-term management of this patient?
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Peutz-Jegher’s Syndrome (harmatomatous polyps)
Mucocutaneous pigmentation (mouth, genitalia)
Early cancer screening!
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What cutaneous finding is associated with Celiac disease?
Dermatitis herpetiformis
(IgA depositions in dermal papillae)
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Where in the GI tract is this?
What kind of cells are indicated by the blue arrows?
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Small intestine
Goblet cells
What hisologic findings are present in Crohn’s disease, but absent in Ulcerative Colitis? (2)
Non-caseating granuloma
Transmural ulceration/fistula
Which SI abnormality is associated with mucocutaneous melanin pigmentation?
Peutz-Jegher’s syndrome
What is the histologic hallmark of the ileum?
Peyers patches
(Areas with increased lympohid aggregates usually w/germinal centers, and flatter mucosa)
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Where in the GI tract is this?
What structures are the yellow arrows pointing to?
Blue arrows?
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Yellow arrows = villi
Blue arrows = crypts
What cells give rise to neuroendocrine tumors?
Stem cells
(Stem cell -> Endocrine cell -> neuroendocrine tumor)
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List 3 antibodies that are specific for Celiac disease
- Deaminated Antigliadin IgA (DGP)
- Tissue transglutaminase IgA (TTG-IgA)
- Antiendomysial antibody IgA (EMA-IgA)
However, prevalence of IgA deficiency is higher in Celiac disease pts; check IgG
What is the normal ratio of lymphocytes:epithelial cells in the small intestine?
1:4
What histologic findings would confirm Whipple’s disease?
Lamina propria contains bacteria-filled macrophages that are highlighted with a PAS-D stain
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List 3 genetic associations with Celiac disease
- MHC Class II
- HLA-DQ2
- HLA-DQ8
(not specific for Celiac)
What is the histologic hallmark of the dodenum?
Brunner glands in the mucoa and submucosa
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What causes Peutz-Jegher’s syndrome?
STK11 (aka LKB1)
This is a tumor suppressor gene
Pts have many harmatomatous polyps throughout the GI tract
What histologic changes occur in Celiac disease? (4)
- Shortening and broadening of villi
- Increased intraepithelial lymphocytes
- Inflammation of lamina propria
- Elongation of crypts
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Which structures are indicated in yellow?
Blue?
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Yellow = plicae circularis (projections of lamina propria)
Blue = villi