Villous atrophy in a small bowel biopsy may range from mild to severe.
(1) villous appearance
(2) surface epithelium
all or almost all long and slender
some normal, some broad, short or fused
abnormal with loss of polarity
increased acute and chronic in lamina propria; some intra- epithelial lymphocytes
most broad and short
intraepithelial lymphocytes; increased mononuclear cells
absent or almost absent
marked mononuclear cell infiltrate
• The normal villous height is >= 3 times the length of the crypt.
Crypt atrophy may be accompanied by crypt hyperplasia or hypoplasia.
(1) poor sampling
(2) abnormal orientation to a villous, such as tangential sectioning
While villous atrophy is associated with celiac disease, other diseases (malnutrition, chemotherapy, radiation, endocrine disorders, etc) can also result in the change.
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Specialty: Gastroenterology, Nutrition