Diagnosing Celiac Disease: Role of the Pathologists

Marián Švajdler^{1, 2,} , Ondřej Daum^{1, 3} and Boris Rychlý⁴

¹Šikl’s Department of Pathology, Charles University, Medical Faculty in Pilsen, Czech Republic

²Louis Pasteur University Hospital, Košice, Slovakia

³Medical Faculty Hospital, Pilsen, Czech Republic

⁴Cytopathos s.r.o., Bratislava, Slovakia

Cite this paper:
Marián Švajdler, Ondřej Daum and Boris Rychlý. Diagnosing Celiac Disease: Role of the Pathologists. International Journal of Celiac Disease. 2014; 2(2):70-75. doi: 10.12691/ijcd-2-2-10

Abstract

Duodenal biopsy is an essential component in the diagnosis of celiac disease (CD). Although the classical findings of increased number of intraepithelial lymphocytes, crypt hyperplasia and villous atrophy are very characteristic, the diagnosis cannot be achieved on the basis of histopathology alone, as there are many entities that can mimic CD and a close collaboration of a pathologist and a clinician specialist is needed. In a patient with suspected CD, pathologist should describe essential histopathological findings and offer differential diagnosis when appropriate. The most important recent changes in the diagnostic criteria for CD include lower numbers of intraepithelial lymphocytes that are considered to be normal and recommendation to perform biopsies from the proximal part of the duodenum in addition to the distal duodenal biopsies.

Keywords:
celiac disease histopathology differential diagnosis

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