What is the key histologic feature of lymphangiectasia on biopsy?

• A. Dilated lacteals in the intestinal mucosa
• B. Villous atrophy with lymphocytic infiltration
• C. Submucosal fibrosis
• D. Necrotizing enteritis

Answer: (C)

The key histologic feature of lymphangiectasia is dilation of the intestinal lymphatic vessels within the mucosa—the lacteals of the villi. On biopsy these lymphatic channels appear enlarged and may be distended with chyle, reflecting impaired lymph drainage. This finding directly points to lymphangiectasia and explains the associated protein-losing enteropathy. Other patterns, like villous atrophy with lymphocytic infiltration, point to celiac-type diseases; submucosal fibrosis suggests chronic inflammatory or fibrotic processes; and necrotizing enteritis shows tissue necrosis. The presence of dilated lacteals in the mucosa best fits lymphangiectasia.