Statistics: H&E: IIIa vs IIIb, p=0.91; IIIa vs IIIc, p=0.96 IIIb vs IIIc, p=0.96. CD3+: IIIa vs IIIb, p=0.84; IIIa vs IIIc, p=0.92; IIIb vs IIIc, p=0.98.

Note. The subclassification of the Marsh III lesion has, to our knowledge, never been subject to critical analysis despite its widespread adoption, as almost a ‘matter of faith’. Here we show that the IEL counts across each of these subdivisions reveal no statistical differences. This is most worrying, since the subdivisions were supposed to represent specific, detectable and progressively deteriorating pathologies during the terminal phases of mucosal flattening. Moreover, despite smaller numbers, no detectable differences in CD3+ IEL were detected between the IIIa, b and c subdivisions of the specimens analysed, in parallel with other findings 28.

IEL, intraepithelial lymphocytes.