Answer is C (Whipple's Disease): An intestinal biopsy is diagnostic/specific for malabsorption due to Whipple's disease. Three most commonly asked forms of Malabsorption Syndromes Whipple's Disease Tropical Sprue Coeliac Disease Malabsorption syndrome with systemic Malabsorption syndrome of infectious Malabsorption syndrome of non infectious features with infectious etiology etiology without systemic features etiology without systemic features Etiology Etiology Etiology Gram negative actinomycetee Caused by some strains of E.coli Caused by intolerance to 'gliadin' gluten a Tropheryma whippelii protein found in wheat rye, barley . Biopsy Biopsy Biopsy Biopsy is Abnormal and Biopsy is abnormal but not Biopsy is abnormal but not specific/diagnostic specific/diagnostic specific/diagnostic Lamina Propria is infiltrated with Shoened, thickened villi increased Blunting and flattening surface with villi macrophages containing PAS positive crypt depth infiltration by either absent or broad and sho glycoproteins and rod shaped bacilli mononuclear cells Crypts are elongated