Stomach: Difference between revisions

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{{Top
<noinclude>{{Top
|author1=[[User:Mikael Häggström|Mikael Häggström]]
|author1=[[User:Mikael Häggström|Mikael Häggström]]
|author2=
|author2=
}}
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{{Endoscopic biopsies}}
==Presentations==
==Presentations==
:*[[Gastric polyp]]
:*[[Gastric polyp]]
:*[[Stomach biopsy for Helicobacter pylori]]
:*[[Stomach biopsy for Helicobacter pylori]]
:*[[Stomach tumor]]
:*[[Gastric sleeve]]
{{Comprehensiveness}}</noinclude>
==Microscopic evaluation==
Generally screen for:
<gallery mode=packed heights=200>
File:Histopathology of gastric adenoma and adenocarcinoma.jpg|Gastric '''adenomas''' and '''adenocarcinomas'''. {{further|Stomach tumor}}
File:Histopathology of mucosal plasma cell infiltrate in chronic gastritis.jpg|thumb|'''[[Gastritis]]''', with neutrophils indicating acute gastritis, and plasma cells (pictured) indicating chronic gastritis.<ref name=PathologyOutlinesAcute>{{cite web|url=https://www.pathologyoutlines.com/topic/stomachacutegastritis.html|title=Stomach - Gastritis - Acute gastritis|author=Elliot Weisenberg|website=pathologyOutlines}} Topic Completed: 1 August 2012. Minor changes: 31 August 2020</ref><ref>{{cite web|url=https://www.pathologyoutlines.com/topic/stomachchronicgastritis.html|title=Stomach - Gastritis - Chronic gastritis|author=Elliot Weisenberg|website=PathologyOutlines}} Topic Completed: 1 August 2012. Minor changes: 31 August 2020</ref>
File:Histopathology of reactive gastropathy, annotated.jpg|thumb|'''Reactive gastropathy''', which is a triad of:<ref name=pmid16939055>{{Cite journal  | last1 = Genta | first1 = RM. | title = Differential diagnosis of reactive gastropathy. | journal = Semin Diagn Pathol | volume = 22 | issue = 4 | pages = 273-83 | month = Nov | year = 2005 | doi =  | PMID = 16939055 }}</ref><br>- '''Foveolar hyperplasia''' (black arrow), generally seen as a tortuosity in the "neck" region of the gastric glands.<br>- Scant acute and chronic '''inflammatory''' cells (white arrow).<br>- '''Smooth muscle hyperplasia''' (black oval)
File:Helicobacter pylori, Gastric Mucosa, H&E (390307642).jpg|{{Comprehensive-begin}}Look for '''[[Helicobacter pylori]]''' even without signs of gastritis.{{Comprehensive-end}}<ref group=note>H. pylori is very unlikely without gastritis or reactive changes.</ref>
</gallery>


==Microscopic evaluation==
===Microscopy report===
Generally screen for '''gastritis''':
Example in case of normal findings:
*'''Mild acute gastritis:'''<ref name=PathologyOutlinesAcute>{{cite web|url=https://www.pathologyoutlines.com/topic/stomachacutegastritis.html|title=Stomach - Gastritis - Acute gastritis|author=Elliot Weisenberg|website=pathologyOutlines}} Topic Completed: 1 August 2012. Minor changes: 31 August 2020</ref>
{|class=wikitable
:*Modest '''edema''' of lamina propria
| {{Moderate-begin}}Stomach, biopsy:{{Moderate-end}} Gastric {{Moderate-begin}}oxyntic/antral{{Moderate-end}} mucosa without significant histopathologic changes.<br>{{Moderate-begin}}Negative for ''Helicobacter {{Comprehensive-begin}}pylori{{Comprehensive-end}}'' organisms on H&E slide.{{Moderate-end}}
:*'''Vascular congestion'''
|}
:*Scattered '''neutrophils'''
<noinclude>{{Bottom}}</noinclude>
:*Mucosal '''hemorrhage'''
:*Intact epithelium
*'''Moderate to severe acute gastritis''':<ref name=PathologyOutlinesAcute/>
:*'''Loss of superficial epithelium''' above the muscularis mucosa
:*'''Hemorrhage'''
:*Variable infiltrate with '''neutrophils'''
:*Fibrinopurulent luminal '''exudate'''
:*Nearby epithelium may show '''regenerative''' changes
*'''Chronic gastritis'''<ref>{{cite web|url=https://www.pathologyoutlines.com/topic/stomachchronicgastritis.html|title=Stomach - Gastritis - Chronic gastritis|author=Elliot Weisenberg|website=PathologyOutlines}} Topic Completed: 1 August 2012. Minor changes: 31 August 2020</ref>
:*Presence of '''plasma cells''', '''lymphocytes''', and occasionally lymphoid '''follicles'''. 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
{{Bottom}}

Latest revision as of 23:33, 15 July 2026

Author: Mikael Häggström [note 1]

Endoscopic biopsies   edit
Mostly:

Presentations

Comprehensiveness

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

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

Microscopic evaluation

Generally screen for:

  • Gastric adenomas and adenocarcinomas. Further information: Stomach tumor
    Gastric adenomas and adenocarcinomas. Further information: Stomach tumor
  • Gastritis, with neutrophils indicating acute gastritis, and plasma cells (pictured) indicating chronic gastritis.[1][2]
    Gastritis, with neutrophils indicating acute gastritis, and plasma cells (pictured) indicating chronic gastritis.[1][2]
  • Reactive gastropathy, which is a triad of:[3] - Foveolar hyperplasia (black arrow), generally seen as a tortuosity in the "neck" region of the gastric glands. - Scant acute and chronic inflammatory cells (white arrow). - Smooth muscle hyperplasia (black oval)
    Reactive gastropathy, which is a triad of:[3]
    - Foveolar hyperplasia (black arrow), generally seen as a tortuosity in the "neck" region of the gastric glands.
    - Scant acute and chronic inflammatory cells (white arrow).
    - Smooth muscle hyperplasia (black oval)
  • ((Look for Helicobacter pylori even without signs of gastritis.))[note 2]
    ((Look for Helicobacter pylori even without signs of gastritis.))[note 2]

Microscopy report

Example in case of normal findings:

(Stomach, biopsy:) Gastric (oxyntic/antral) mucosa without significant histopathologic changes.
(Negative for Helicobacter ((pylori)) organisms on H&E slide.)

Notes

  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. ↑ H. pylori is very unlikely without gastritis or reactive changes.

Main page

References

  1. ↑ Elliot Weisenberg. Stomach - Gastritis - Acute gastritis. pathologyOutlines. Topic Completed: 1 August 2012. Minor changes: 31 August 2020
  2. ↑ Elliot Weisenberg. Stomach - Gastritis - Chronic gastritis. PathologyOutlines. Topic Completed: 1 August 2012. Minor changes: 31 August 2020
  3. ↑ Genta, RM. (Nov 2005). "Differential diagnosis of reactive gastropathy. ". Semin Diagn Pathol 22 (4): 273-83. PMID 16939055. 

Image sources


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