Intestinal lymphocytic epithelioganglionitis: A unique combination of inflammation in bowel dysmotility: A histopathological and immunohistochemical analysis of 28 cases

Histopathology

Volumn 54, Issue 5, 2009, Pages 539-549

  Veress, Béla ^a   Nyberg, Björn ^b   Törnblom, Hans ^c   Lindberg, Greger ^c,d  

^a LUND UNIVERSITY HOSPITAL   (Sweden)

^b Departments of Surgery   (United States)

^c KAROLINSKA INSTITUTE   (Sweden)

^d KAROLINSKA UNIVERSITY HOSPITAL   (Sweden)

Author keywords

Functional bowel disorders; Immunohistochemistry; Inflammation; Intestinal pseudo obstruction; Visceral neuropathy

Indexed keywords

GENE PRODUCT; NEURON SPECIFIC ENOLASE; PROTEIN BCL 2; SYNAPTOPHYSIN;

ADULT; ARTICLE; CD3+ T LYMPHOCYTE; CELIAC DISEASE; CELL COUNT; CELL HYPERPLASIA; CLINICAL ARTICLE; CYTOTOXIC T LYMPHOCYTE; DISEASE SEVERITY; FEMALE; GANGLIONEURITIS; HISTOPATHOLOGY; HUMAN; HUMAN TISSUE; IMMUNOHISTOCHEMISTRY; INTERSTITIAL CELL OF CAJAL; INTESTINAL DYSMOTILITY; JEJUNUM BIOPSY; LYMPHOCYTIC INFILTRATION; LYMPHOCYTOSIS; MALE; MEDICAL RECORD REVIEW; MYENTERIC PLEXUS; NERVE CELL; NEUROPATHY; PRIORITY JOURNAL; RETROSPECTIVE STUDY; SMALL INTESTINE DISEASE;

ADULT; FEMALE; GASTROINTESTINAL MOTILITY; HUMANS; IMMUNOHISTOCHEMISTRY; INFLAMMATION; INFLAMMATORY BOWEL DISEASES; LYMPHOCYTOSIS; MALE; MIDDLE AGED; MYENTERIC PLEXUS;

EID: 64549162837     PISSN: 03090167     EISSN: 13652559     Source Type: Journal    
DOI: 10.1111/j.1365-2559.2009.03265.x     Document Type: Article

References (33)

1. Krishnamurthy S, Schuffler MD. Pathology of neuromuscular disorders of the small intestine and colon. Gastroenterology 1987 93 610 639.
2. De Giorgio R, Stanghellini V, Barbara G et al. Primary enteric neuropathies underlying gastrointestinal motor dysfunction. Scand. J. Gastroenterol. 2000 35 114 122.
3. Wood JD. Neuropathy in the brain-in-the-gut. Eur. J. Gastroenterol. Hepatol. 2000 12 597 600.
4. De Giorgio R, Camilleri M. Human enteric neuropathies: morphology and molecular pathology. Neurogastroenterol. Motil. 2004 16 515 531.
5. McDonald GB, Schuffler MD, Kadin ME, Tytgat GN. Intestinal pseudoobstruction caused by diffuse lymphoid infiltration of the small intestine. Gastroenterology 1985 89 882 889.
6. Krishnamurthy S, Schuffler MD, Belic L, Schweid AI. An inflammatory axonopathy of the myenteric plexus producing a rapidly progressive intestinal pseudoobstruction. Gastroenterology 1986 90 754 758.
7. Raymond L, Lach B, Shamji FM. Inflammatory aetiology of primary oesophageal achalasia: an immunohistochemical and ultrastructural study of Auerbach's plexus. Histopathology 1999 35 445 453.
8. Clark SB, Rice TW, Tubbs RR, Richter JE, Goldblum JR. The nature of the myenteric infiltrate in achalasia: an immunohistochemical analysis. Am. J. Surg. Pathol. 2000 24 1153 1158.
9. De Giorgio R, Barbara G, Stanghellini V et al. Clinical and morphofunctional features of idiopathic myenteric ganglionitis underlying severe intestinal motor dysfunction: a study of three cases. Am. J. Gastroenterol. 2002 97 2454 2459.
10. Schappi MG, Smith VV, Milla PJ, Lindley KJ. Eosinophilic myenteric ganglionitis is associated with functional intestinal obstruction. Gut 2003 52 752 755.
11. De Giorgio R, Guerrini S, Barbara G et al. Inflammatory neuropathies of the enteric nervous system. Gastroenterology 2004 126 1872 1883.
12. Thompson WG, Creed F, Drossman DA, Heaton KW, Mazzacca G. Functional bowel disease and functional abdominal pain. Gastroenterol. Int. 1992 5 75 91.
13. Thompson WG, Longstreth GF, Drossman DA, Heaton KW, Irvine EJ, Muller-Lissner SA. Functional bowel disorders and functional abdominal pain. Gut 1999 45 (Suppl 2 II43 II47.
14. Wingate D, Hongo M, Kellow J, Lindberg G, Smout A. Disorders of gastrointestinal motility: towards a new classification. J. Gastroenterol. Hepatol. 2002 17 (Suppl S1 S14.
15. Veress B, Franzen L, Bodin L, Borch K. Duodenal intraepithelial lymphocyte-count revisited. Scand. J. Gastroenterol. 2004 39 138 144.
16. Törnblom H, Lindberg G, Nyberg B, Veress B. Full-thickness biopsy of the jejunum reveals inflammation and enteric neuropathy in irritable bowel syndrome. Gastroenterology 2002 123 1972 1979.
17. Chang F, Mahadeva U, Deere H. Pathological and clinical significance of increased intraepithelial lymphocytes (IELs) in small bowel mucosa. Apmis 2005 113 385 399.
18. Snijders F, Meenan J, van den Blink B, van Deventer SJ, ten Kate FJ. Duodenal intraepithelial and lamina propria T lymphocytes in human immunodeficiency virus-infected patients with and without diarrhoea. Scand. J. Gastroenterol. 1996 31 1176 1181.
19. Hayat M, Cairns A, Dixon MF, O'Mahony S. Quantitation of intraepithelial lymphocytes in human duodenum: what is normal? J. Clin. Pathol. 2002 55 393 394.
20. Einarsson K, Eusufzai S, Johansson U, Lofberg R, Theodorsson E, Veress B. Villous atrophy of distal ileum and lymphocytic colitis in a woman with bile-acid malabsorption. Eur. J. Gastroenterol. Hepatol. 1992 4 585 590.
21. Knowles CH, Silk DB, Darzi A et al. Deranged smooth muscle alpha-actin as a biomarker of intestinal pseudo-obstruction: a controlled multinational case series. Gut 2004 53 1583 1589.
22. Merry DE, Veis DJ, Hickey WF, Korsmeyer SJ. bcl-2 protein expression is widespread in the developing nervous system and retained in the adult PNS. Development 1994 120 301 311.
23. Huizinga JD, Thuneberg L, Kluppel M, Malysz J, Mikkelsen HB, Bernstein A. W/kit gene required for interstitial cells of Cajal and for intestinal pacemaker activity. Nature 1995 373 347 349.
24. Rumessen JJ, Thuneberg L. Interstitial cells of Cajal in human small intestine. Ultrastructural identification and organization between the main smooth muscle layers. Gastroenterology 1991 100 1417 1431.
25. Lu G, Qian X, Berezin I, Telford GL, Huizinga JD, Sarna SK. Inflammation modulates in vitro colonic myoelectric and contractile activity and interstitial cells of Cajal. Am. J. Physiol. 1997 273 G1233 G1245.
26. Vanderwinden JM, Rumessen JJ, De Laet MH, Vanderhaeghen JJ, Schiffmann SN. CD34+ cells in human intestine are fibroblasts adjacent to, but distinct from, interstitial cells of Cajal. Lab. Invest. 1999 79 59 65.
27. He CL, Burgart L, Wang L et al. Decreased interstitial cell of Cajal volume in patients with slow-transit constipation. Gastroenterology 2000 118 14 21.
28. Porcher C, Baldo M, Henry M, Orsoni P, Jule Y, Ward SM. Deficiency of interstitial cells of Cajal in the small intestine of patients with Crohn's disease. Am. J. Gastroenterol. 2002 97 118 125.
29. Blennerhassett MG, Vignjevic P, Vermillion DL, Collins SM. Inflammation causes hyperplasia and hypertrophy in smooth muscle of rat small intestine. Am. J. Physiol. 1992 262 G1041 G1046.
30. Hadzijahic N, Renehan WE, Ma CK, Zhang X, Fogel R. Myenteric plexus destruction alters morphology of rat intestine. Gastroenterology 1993 105 1017 1028.
31. Deniz M, Kilinc M, Hatipoglu ES. Morphological alterations in small intestine of rats with myenteric plexus denervation. Eur. Surg. Res. 2004 36 152 158.
32. Brown I, Mino-Kenudson M, Deshpande V, Lauwers GY. Intraepithelial lymphocytosis in architecturally preserved proximal small intestinal mucosa: an increasing diagnostic problem with a wide differential diagnosis. Arch. Pathol. Lab. Med. 2006 130 1020 1025.
33. Kakar S, Nehra V, Murray JA, Dayharsh GA, Burgart LJ. Significance of intraepithelial lymphocytosis in small bowel biopsy samples with normal mucosal architecture. Am. J. Gastroenterol. 2003 98 2027 2033.