1. Counting Intraepithelial Lymphocytes: A Comparison Between Routine Staining and CD3 Immunohistochemistry.
- Author
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Cooper R, Papworth NJ, Harris C, Horne J, Lai J, Lai J, Rajak R, Valentine KM, Gaya SO, and Carr NJ
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Biopsy, CD3 Complex metabolism, Celiac Disease diagnosis, Celiac Disease pathology, Child, Child, Preschool, Coloring Agents chemistry, Duodenum cytology, Duodenum pathology, Eosine Yellowish-(YS) chemistry, Female, Hematoxylin chemistry, Humans, Immunohistochemistry methods, Intestinal Mucosa cytology, Intestinal Mucosa pathology, Intraepithelial Lymphocytes immunology, Male, Middle Aged, Observer Variation, Staining and Labeling methods, Young Adult, CD3 Complex analysis, Intraepithelial Lymphocytes metabolism, Lymphocyte Count methods
- Abstract
Counting intraepithelial lymphocytes (IELs) is a key part of the assessment of duodenal biopsies. Immunohistochemistry (IHC) for CD3 can aid identification of lymphocytes in this context, but it is not evident that counts on hematoxylin and eosin (H&E) and CD3 are comparable. This study aimed to compare the IEL counts in duodenal biopsies using H&E stains and CD3 IHC, and to examine the interobserver variability. Thirty-five paired H&E and CD3 sections were reviewed by 6 pathologists who counted the number of IELs per 100 enterocytes. The counts were categorized into groups: normal (<25 lymphocytes), mildly raised (25-40 lymphocytes), and markedly raised (>40 lymphocytes). CD3 IHC was associated with significantly higher IEL counts than H&E. Four cases with normal H&E counts had raised counts with CD3. There was moderate agreement between observers for both H&E and CD3. Lack of concordance between CD3 and H&E IEL counts suggests that counts derived from the 2 methods may not be comparable to each other and should not be considered equivalent. There was no significant improvement in interobserver variability with CD3 IHC.
- Published
- 2020
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