Histopathological Aspects of Coeliac Disease

Currently, the diagnosis of coeliac disease (CD) is based on the combination of raised serum anti-tissue transglutaminase or antiendomysial antibodies and the presence of histological alterations of variable degree in the duodenal mucosa. Interpretation of duodenal biopsies depends on a number of variables - biopsy number, size, orientation, handling and staining - and the lack of standardisation may cause diagnostic controversy or even misdiagnosis. Biopsy handling and orientation are of utmost importance in order to avoid artifacts that may impair the pathologist's ability to detect pathology. Immunostaining with anti-CD3 monoclonal antibody should be carried out and a simplified histological classification may help to distinguish atrophic from non-atrophic stages of CD enteropathy, to differentiate it from other entities and from some complications as refractory CD and lymphoma. © 2011 Touch Briefings.