Gastritis
Author:
Mikael Häggström [note 1]
Inflammation of the stomach. If biopsy is at the esophagus, evaluate as gastroesophageal junction.
Contents
Comprehensiveness
On this resource, the following formatting is used for comprehensiveness:
- Minimal depth
- (Moderate depth)
- ((Comprehensive))
Microscopy evaluation
Look for chronic or acute gastritis. If either is present, still look for the other.
Chronic gastritis
- Chronic gastritis[1]
- Presence of plasma cells, lymphocytes, and occasionally lymphoid follicles. Scattered single plasma cells and lymphocytes is normal, and the threshold is subjective, but one definition of chronic gastritis is when seeing chronic inflammation at 4x magnification (as increased dots separating glands)[2] Eosinophils and neutrophils may be present.
- Reduced mucin in the cytoplasm
- Enlargement of nuclei and nucleoi
- Subnuclear vacuolation in antral glands or pits (which is PAS negative)
- Intestinal metaplasia: with partial replacement of the mucosa of the antrum and body with metaplastic goblet cells of intestinal morphology, absorptive cells and Paneth cells.
Updated Sydney System for visual classification of gastritis.[3]
Extensive atrophy of oxyntic glands in fundus/corpus causes pseudo-pyloric metaplasia.[3]
When there is at least (mild or) moderate gastritis, especially if relatively superficial, also evaluate as a stomach biopsy for Helicobacter pylori.
Acute gastritis
- Mild acute gastritis:[4]
- Modest edema of lamina propria
- Vascular congestion
- Scattered neutrophils
- Mucosal hemorrhage
- Intact epithelium
Early acute superficial gastritis: Marked neutrophilic infiltrates appear in the mucous neck region and lamina with a pit micoabscess.[3]
- Moderate to severe acute gastritis:[4]
- Loss of superficial epithelium above the muscularis mucosa
- Hemorrhage
- Variable infiltrate with neutrophils
- Fibrinopurulent luminal exudate
- Nearby epithelium may show regenerative changes
Microscopy report
- Mild and/or chronic gastritis and severity
- (If present, state if positive or negative for Helicobacter pylori organisms.)
Chronic gastritis without neutrophils is preferably also termed "non-active".
Example:
(Stomach, biopsy:)
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Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
- ↑ The combination of atrophy and gastritis (especially when deeper than submucosal) helps the clinician to potentially make a diagnosis of atrophic gastritis.
Main page
References
- ↑ Elliot Weisenberg. Stomach - Gastritis - Chronic gastritis. PathologyOutlines. Topic Completed: 1 August 2012. Minor changes: 31 August 2020
- ↑ Lysandra Voltaggio, Johns Hopkins Department of Pathology (2018-10-31). Gastritis: A Pattern Based Approach. Arizona Society of Pathologists.
- ↑ 3.0 3.1 3.2 3.3 Carrasco G, Corvalan AH (2013). "Helicobacter pylori-Induced Chronic Gastritis and Assessing Risks for Gastric Cancer.
". Gastroenterol Res Pract 2013: 393015. doi: . PMID 23983680. PMC: 3745848. Archived from the original. .
Figures - available via license: Creative Commons Attribution 3.0 Unported - ↑ 4.0 4.1 Elliot Weisenberg. Stomach - Gastritis - Acute gastritis. pathologyOutlines. Topic Completed: 1 August 2012. Minor changes: 31 August 2020
Image sources