increased apoptosis in epithelium and lamina propria

2016-08-30_0001.jpg

Author: Dr Tim Bracey

22/08/2016        12:25 PM        Suffix - Tissue Types                    HI022310Y/16
                                                   - Not Fully Authorised -
     1 - Duodenal Biopsy                       
 
 Report sequence 1              Typed                                               30/08/2016 12:06
                                          By   Dr C Holgate                             CELLPATH (Dr Holgate) PC
NATURE OF SPECIMEN:    2WW
1.  D2 x 4.
CLINICAL DETAILS:
IDA.  CLO.
GROSS DESCRIPTION:
Four biopsies  measuring: largest 4mm, smallest 2mm. 
s4 1 NSW   PJ/ID
HISTOLOGY:
Reported by:

Clive. THere is increased apoptotic debris at the ends of duodenal villi. consider
drug related enteritis and correlate with clinical history. Similar
changes can be seen in colonic mucosa related to NSAID use. Does the
patient have diarrhoea? otherwise no villous atrophy, no increased IEL
or Giardia. TB

Novelli, Marco <m.novelli@ucl.ac.uk>
Tue 30/08/2016 13:05
To:
Bracey Tim (PLYMOUTH HOSPITALS NHS TRUST);
Shepherd Neil.A (GLOUCESTERSHIRE HOSPITALS NHS FOUNDATION TRUST);
Would call that apoptotic personally!  Certainly unusual but would be more so if at crypt bases – not in your photo. 
 
Need to correlate with clinical – does she have diarrhoea?  Does not look anything like coeliac so if symptomatic then would raise the possibility of a medication –associated “enteritis”.  Otherwise I would just mention in passing.
 
Marco


Tue 30/08/2016 13:14
Inbox
Agree with Marco
 
Drugs every time…………..
 
Neil
Professor Neil A Shepherd, DM FRCPath 
Professor of Gastrointestinal Pathology & Consultant Histopathologist 
Gloucestershire Cellular Pathology Laboratory 
Cheltenham General Hospital 
Sandford Road 
CHELTENHAM 
Glos  GL53 7AN 
United Kingdom 
Tel: 0044- (0)3004-223304 
Mobile: 0044- (0)7785-562280 
Fax: 0044- (0)3004-223318 
E-mail (work): neil.a.shepherd@nhs.net
E-mail (home): neilxshepherd@gmail.com