Dr Sampurna Roy MD

Small Intestinal Pathology



August  2009

- Interpretation of Large Intestinal Biopsies

- Assessment of abnormalities -1

- Assessment of abnormalities - 2 

- Assessment of abnormalities - 3

An outline of the anatomy and normal histology of the  stomach for pathologists.

Reporting of gastric biopsies (non-neoplastic gastric lesions).

Pathology and pathogenesis of peptic ulcer.

Acute Gastritis 

Chronic Gastritis 

Autoimmune Gastritis  (Type A) 

Reactive /Reflux/ Chemical Gastritis (Type C)

Lymphocytic Gastritis

Collagenous Gastritis

Granulomatous Gastritis

Eosinophilic Gastritis

Gastric Xanthoma/Xanthelasma

Other Non-Neoplastic Gastric Lesions

Benign tumour and tumour- like lesions

Gastric Lymphoma

Gastric Carcinoid Tumour

Gastrointestinal Stromal Tumour 

Gastric Epithelial Dysplasia

Early Gastric Carcinoma

Gross Examination of the Gastrectomy Specimen 

Drug related lesions of the gastrointestinal tract




Cytomegalovirus infection


Hookworm Infection



Mycobacterium Avium Intracellulare


Whipple's disease


Meckel's diverticulum is derived from an abnormal persistence of the proximal part of the vitelline duct.

It is situated  80cm proximal to the ileocaecal junction  on the antimesenteric border.

Macroscopically, it is a small pouch or a blind segment
which varies in length from less  than 1cm to 8cm , and lumen diameter is greater than that of the ileum.

This is a true diverticulum containing all three layers of the bowel wall (mucosa, submucosa and muscularis propra).

Histology reveals normal small intestinal mucosa. Often heterotopic rests of gastric and colonic mucosa  or pancreatic tissue may be present.

 Image1:click here (webpath)  ;  Image2: click here

Complications of Meckel's diverticulum:

1) inflammation 

2) perforation, 

3) vesiculodiverticular fistula,

4) ulceration (peptic ulceration occurs in the ileum adjacent to the heterotopic gastric mucosa)

5) haemorrhage (painless bleeding is common symptom in diverticulitis)

6) intussusception 

7) intestinal obstruction from attached bands and tumours.

8)Carcinoid tumours have been often reported.

9)Other tumours arising in Meckel's diverticulum include- adenocarcinoma, villous adenoma, leiomyoma, leiomyosarcoma, malignat melanoma.

Visit: Lesions causing small bowel obstruction and bleeding  ; Ischemic bowel disease


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Histopathological image of Meckel's diverticulum

Heterotopic rests of gastric mucosa (low power)

Heterotopic rests of gastric mucosa (high power)

Normal histology of the small intestine for anatomic pathologists

An approach to evaluation of small intestinal biopsy.

Malabsorption syndrome (causes  and clinical investigations)

Tropical Sprue

Coeliac Disease

Enteropathy-associated T-cell lymphoma

Intestinal lymphan-giectasia

Lesions causing small bowel obstruction and bleeding - Intussusception : Adhesions : Volvulus

Ischemic bowel disease 

Duodenal  Gangliocytic Paraganglioma

Lymphoma of the small intestine

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