1. © The Author(s) 2015. Published by Science and Education Publishing.
Table 3. Overview of histological lesions of duodenal mucosa in CD (modified from Marsh classification)1
Type
Stage
Grade
Epithelium cells (EpC)2
Villi3
Crypts
IEL/EpC
Description (Figure)
Normal size and height
Unaltered
<40/1001
Preinfiltrative mucosa (Figure 2A, Figure 3A, Figure 3B)* 1 I A
>40/100
Infiltrative lesion of the epithelium (Figure 3C, Figure 4A) 2 II
Proliferation
Crypt hyperplasia, hyperplastic mucosa 3a
IIIA B1
Height of EpC reduced
Partial atrophy
Classical lesion (Figure 2B, Figure 2C, Figure 3E, Figure 3F)** 3b
IIIB
Subtotal atrophy
Classical lesion (Figure 2D, Figure 3D, Figure 4B)** 3c
IIIC B2
Cuboidal EpC (not differentiated)
Progressed lesion, lymphocyte infiltration in lamina propria (Figure 4C, Figure 4D)***
IV4
Cuboidal EpC (not differentiated, no brush border)
Total atrophy4
hypoplastic
<40/100
End stage lesion (massive lymphocyte infiltration in lamina propria, but no IEL), hypoplastic crypts and total absence of villi.
* Serologic markers might be positive in about 5 % of cases with HLA DQ2 and/or HLA DQ8 genotypes (latent form of CD)
** Referred to as destructive (Marsh, 1992)
***Lymphocyte infiltration in lamina propria
1 the original borderline value has been claimed 25 IEL /100 EpC (Marsh and Crove, 1995)
2 schematic view of the lesion dynamics shown on Figure 1A; 3 schematic view of lesion dynamics shown on Figure 1B
4 some authors do not accept this category suggesting its cancelling.
Andrej Beseda et al. The Malabsorption Syndrome versus Celiac Disease: A Diagnostic Reappraisal. International Journal
of Celiac Disease, 2015, Vol. 3, No. 4, doi: /ijcd-3-4-5
© The Author(s) Published by Science and Education Publishing.