Intraepithelial Lymphocytes
Also written as IEL.
Upper GI endoscopy is performed with biopsies taken of the duodenum, and on microscopic examination show absence of villi, increased surface intraepithelial lymphocytes, and hyperplastic appearing crypts.
What our notes say
- Upper GI endoscopy is performed with biopsies taken of the duodenum, and on microscopic examination show absence of villi, increased surface intraepithelial lymphocytes, and hyperplastic appearing crypts. (Gastrointestinal and liver — Past Paper)
- Characterised by villous atrophy, crypt hyperplasia, and increased intraepithelial lymphocytes (IELs) (GASTROINTESTINAL PATHOLOGY (Part 2) — Notes)
- • increased crypt length; oXen patchy, sub-total intraepithelial lymphocytes; few eosinophils (7. Approach to a child with diarrhea & constipation)
- Intraepithelial lymphocytes (IEL) act to protect the host against viral and bacterial pathogens encountered in the gut and secrete cytokines. (Comprehensive Immunology Quiz — Antigen Processing to B Cell — MCQ Bank)
- Microscopic colitis: Diagnosis requires biopsy despite normal endoscopic findings; collagenous type shows a dense subepithelial collagen layer; lymphocytic type shows a greater increase in intraepithelial lymphocytes (IELs). (GASTROINTESTINAL PATHOLOGY (Part 3) — Notes)
- | Key histology | Dense subepithelial collagen layer + increased intraepithelial lymphocytes + mixed lamina propria infiltrate | Normal subepithelial collagen; greater increase in intraepithelial lymphocytes (>1 T lymphocyte per 5 colonocytes) | (GASTROINTESTINAL PATHOLOGY (Part 3) — Notes)
Study material on Intraepithelial Lymphocytes
Practice questions on Intraepithelial Lymphocytes
A 50-year-old male presents with a history of chronic diarrhoea, weight loss, and abdominal pain. Small bowel biopsy shows villous atrophy, increased intraepithelial lymphocytes, and positive anti-tTG antibodies. What is the most appropriate long-term management?
- Low-fat diet
- Antibiotic therapy
- Gluten-free diet
- Prokinetic agents
Answer: C. The diagnosis of celiac disease, confirmed by biopsy and serology, requires a lifelong gluten-free diet to manage symptoms and prevent complications.