What are typical histologic features of eosinophilic enteritis?

• A. Prominent eosinophilic infiltration of the mucosa, often with varying villous blunting.
• B. Neutrophilic infiltration with crypt abscesses
• C. Lymphocytic infiltration without eosinophils
• D. Granulomatous inflammation with giant cells

Answer: (A)

The main idea here is that eosinophilic enteritis shows eosinophil-predominant inflammation in the intestinal mucosa. On biopsy you typically see a prominent infiltration of eosinophils within the mucosal layer, and this inflammatory assault can lead to damage that causes villous blunting. The eosinophilic infiltrate may be patchy and, in more extensive disease, can extend into the submucosa or deeper, but the mucosal eosinophils are the hallmark finding.

This pattern distinguishes it from other inflammatory patterns. Neutrophilic infiltration with crypt abscesses is more characteristic of inflammatory bowel diseases like ulcerative colitis. Lymphocytic infiltration without eosinophils points toward lymphocytic enteritis or related conditions. Granulomatous inflammation with giant cells is typical of granulomatous enteritis, such as Crohn disease.