This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Systemic Pathology, Subject name: Pathology
Morphological features of celiac disease include all except: 
Select and explain. 
A. Increase in intraepithelial lymphocytes, B. Increase in crypt: villous ratio, C. Distended macrophages with PAS positive granules in lamina propria, D. Elongated hyperplastic and touous crypts
C: Distended macrophages with PAS positive granules in lamina propria
Answer: C: Distended macrophages with PAS positive granules in lamina propria 
Explanation: - Distended macrophages with PAS positive granules in lamina propria is feature of Whipple's disease not celiac disease. - Remaining all features given in other options are features of celiac disease. CELIAC SPRUE: Associated with HLA- DQ2/ DQ8 Caused d/t intestinal immune reaction to gluten - Major storage protein of wheat & similar grains T-cells & antibodies like anti-tissue transglutaminase Ab, anti-gliadin Ab & anti-endomycial Ab are involved. Celiac disease. (A) Advanced cases of celiac disease show complete loss of villi, or total villous atrophy. Note the dense plasma cell infiltrates in the lamina propria. (B) Infiltration of the surface epithelium by T lymphocytes