Jejunal Biopsy: Criteria and Significance

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Abstract
The classification and diagnostic significance of 1,500 specimens of jejunal mucosa obtained from nine hundred patients are considered. The only biopsies with a positive diagnostic appearance were those obtained in adult coeliac disease, intestinal lipodystrophy and hypogamniaglobulinaemia. Acanthocy- tosis and lymphangiectasis were not encountered in this series. Mucosal abnormalities such as leaves, ridges or convolutions had no diagnostic significance, nor did mild and moderate changes under light histology (Grades I and II), On the evidence available at present a flat mucosa with mosaic pattern anti the associated severe histological changes (Grade III) should be considered diagnostic af adult coeliac disease.