Table 1.
Histopathological classifications of celiac disease
| Marsh 1992 and Rostami et al. 2015 (5, 8, 16, 17) | Rostami et al 1998, 1999 (9, 10) | Oberhuber et al. 1999 (11) | Corazza & Villanacci 2005 (2) | Ensari 2010 (3) |
|---|---|---|---|---|
| Type 0: Microscopic enteritis; normal villi with pathological increase of T lymphocytes, alteration of enterocytes, shortening of microvilli and increased α/β/γ/δ T cell receptors | ||||
| Type 1: Microscopic enteritis: increased IEL count (> 20 IEL/100 enterocytes) | Marsh I: normal villous epithelium > 30 IEL per 100 enterocytes |
Type 1
Infiltrative lesion |
Grade A
No atrophy, normal villous architecture with or without crypt hyperplasia and ≥25 IELs/100 enterocytes |
Type 1
Normal villi with IE lymphocytosis |
|
Type 2
Microscopic enteritis increased IEL count (> 20 IEL/100 enterocytes) and crypt hyperplasia) |
Marsh II: enlarged crypts and influx of inflammatory cells |
Type 2
Crypt hyperplasia |
Grade A | Type 1 |
|
Type 3
Villus effacement and crypt hyperplasia |
Marsh IIIa: (partial VA) shortened blunt villi, infiltration IEL and hyperplastic crypts | Type 3A: Partial |
Grade
B1 villous-crypt ratio <3:1 IEL count of >25/100 enterocytes** |
Type 2 Shortened villi (<3:1 or <2:1 in bulbus) with IE lymphocytosis and crypt hyperplasia |
| Marsh IIIb (subtotal VA) Recognizable atrophic villi, inflammatory cells and enlarged crypts | Type 3B: Subtotal | Grade B1 | Type 2 | |
| Marsh IIIc :(total villous atrophy) total absence of villi, severe atrophic, hyperplastic, infiltrative lesion | Type 3C: Total |
Grade B2
Completely flat atrophic mucosa, no observable villi and ≥25 IELs/100 enterocytes |
Type 3
Completely flat mucosa with IE lymphocytosis and crypt hyperplasia |
|
|
Type 4
Destructive lesion |
Not considered |
Type 4
Destructive lesion |
Not considered | Not considered |