Changes in the Paneth cell population of human small intestine assessed by image analysis of the secretory granule area.

Estimates of the Paneth cell population in human jejunum and ileum were made using measurement of the granule area in micron2 by image analysis in a defined number of crypts. This figure was preferable to granule area per mm as there was a significant difference in crypts per mm between biopsies and surgical samples. In the jejunum no significant difference was found between normal children and adults with and without peptic ulcer. In adults with subtotal or partial villous atrophy the decrease in area was not statistically significant and there was no decrease in area in children with partial villous atrophy and coeliac disease. There was a marked increase in granule area in the jejunum of patients who had had a previous partial gastrectomy which was statistically significant. In the ileum patients with carcinoma of the caecum had higher values than patients with non-inflammatory non-malignant conditions but this was not statistically significant and two patients with Crohn's disease had an increased granule area. Paneth cell populations are affected by alterations in the intestinal luminal environment due to previous surgery or neoplastic or inflammatory disease.