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Author: Mikael Häggström [note 1]

Inflammation of the stomach. If biopsy is at the esophagus, evaluate as gastroesophageal junction.


On this resource, the following formatting is used for comprehensiveness:

  • Minimal depth
  • (Moderate depth)
  • ((Comprehensive))

Microscopy evaluation

Mucosal plasma cell infiltrate in mild chronic gastritis.

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.

When there is at least (mild or) moderate gastritis, especially if relatively superficial, also evaluate as a stomach biopsy for Helicobacter pylori.

Acute gastritis

Histopathology of mild active gastritis, with intraepithelial neutrophils (white arrows) as well as in lamina propria (black arrows).
  • Mild acute gastritis:[4]
  • Modest edema of lamina propria
  • Vascular congestion
  • Scattered neutrophils
  • Mucosal hemorrhage
  • Intact epithelium
  • 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".


(Stomach, biopsy:)
  • (Gastric antral/oxyntic mucosa with) mild chronic (non-active) gastritis((, non-specific))
  • (Negative for Helicobacter pylori organisms on H&E slide.)


  1. 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.
  2. The combination of atrophy and gastritis (especially when deeper than submucosal) helps the clinician to potentially make a diagnosis of atrophic gastritis.

Main page


  1. Elliot Weisenberg. Stomach - Gastritis - Chronic gastritis. PathologyOutlines. Topic Completed: 1 August 2012. Minor changes: 31 August 2020
  2. Lysandra Voltaggio, Johns Hopkins Department of Pathology (2018-10-31). Gastritis: A Pattern Based Approach. Arizona Society of Pathologists.
  3. 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:10.1155/2013/393015. PMID 23983680. PMC: 3745848. Archived from the original. . 
    Figures - available via license: Creative Commons Attribution 3.0 Unported
  4. 4.0 4.1 Elliot Weisenberg. Stomach - Gastritis - Acute gastritis. pathologyOutlines. Topic Completed: 1 August 2012. Minor changes: 31 August 2020

Image sources