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?
Peutz-Jegher’s Syndrome (harmatomatous polyps)
Mucocutaneous pigmentation (mouth, genitalia)
Early cancer screening!
What cutaneous finding is associated with Celiac disease?
Dermatitis herpetiformis
(IgA depositions in dermal papillae)
Where in the GI tract is this?
What kind of cells are indicated by the blue arrows?
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)
Where in the GI tract is this?
What structures are the yellow arrows pointing to?
Blue arrows?
Small Bowel (since contains villi; Large intestine/colon has crypts w/o villi)
Yellow arrows = villi
Blue arrows = crypts
What cells give rise to neuroendocrine tumors?
Stem cells
(Stem cell -> Endocrine cell -> neuroendocrine tumor)
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
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
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
Which structures are indicated in yellow?
Blue?
Yellow = plicae circularis (projections of lamina propria)
Blue = villi
