Gastritis: Difference between revisions
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==Microscopy evaluation== | ==Microscopy evaluation== | ||
[[File:Histopathology of mild active gastritis, annotated.jpg|thumb|230px|Histopathology of '''mild active gastritis''', with intraepithelial neutrophils (white arrows) as well as in lamina propria (black arrows).]] | [[File:Histopathology of mild active gastritis, annotated.jpg|thumb|230px|Histopathology of '''mild active gastritis''', with intraepithelial neutrophils (white arrows) as well as in lamina propria (black arrows).]] | ||
[[File:Updated Sydney System for visual classification of gastritis.png|thumb| | [[File:Updated Sydney System for visual classification of gastritis.png|thumb|340px|Updated Sydney System for visual classification of gastritis.<ref name=Carrasco/>]] | ||
*'''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> | *'''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> | ||
:*Modest '''edema''' of lamina propria | :*Modest '''edema''' of lamina propria | ||
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:*Mucosal '''hemorrhage''' | :*Mucosal '''hemorrhage''' | ||
:*Intact epithelium | :*Intact epithelium | ||
<gallery mode=packed heights= | <gallery mode=packed heights=210px> | ||
File:Histopathology of early acute superficial gastritis.png|Early acute superficial gastritis: Marked neutrophilic infiltrates appear in the mucous neck region and lamina with a pit micoabscess.<ref name=Carrasco>{{cite journal| author=Carrasco G, Corvalan AH| title=Helicobacter pylori-Induced Chronic Gastritis and Assessing Risks for Gastric Cancer. | journal=Gastroenterol Res Pract | year= 2013 | volume= 2013 | issue= | pages= 393015 | pmid=23983680 | doi=10.1155/2013/393015 | pmc=3745848 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23983680 }}<br>[https://www.researchgate.net/publication/256190376_Helicobacter_pylori-Induced_Chronic_Gastritis_and_Assessing_Risks_for_Gastric_Cancer Figures - available via license: Creative Commons Attribution 3.0 Unported]</ref> | File:Histopathology of early acute superficial gastritis.png|Early acute superficial gastritis: Marked neutrophilic infiltrates appear in the mucous neck region and lamina with a pit micoabscess.<ref name=Carrasco>{{cite journal| author=Carrasco G, Corvalan AH| title=Helicobacter pylori-Induced Chronic Gastritis and Assessing Risks for Gastric Cancer. | journal=Gastroenterol Res Pract | year= 2013 | volume= 2013 | issue= | pages= 393015 | pmid=23983680 | doi=10.1155/2013/393015 | pmc=3745848 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23983680 }}<br>[https://www.researchgate.net/publication/256190376_Helicobacter_pylori-Induced_Chronic_Gastritis_and_Assessing_Risks_for_Gastric_Cancer Figures - available via license: Creative Commons Attribution 3.0 Unported]</ref> | ||
</gallery> | </gallery> | ||
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:*'''Subnuclear vacuolation''' in antral glands or pits (which is PAS negative) | :*'''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. | :*'''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. | ||
<gallery mode=packed heights= | <gallery mode=packed heights=210> | ||
File:Histopathology of antral mucosa with atrophy.png|In '''intestinal metaplasia''' (seen at bottom of this antral mucosa), also look for '''atrophy''' as pictured.<ref name=Carrasco/><ref group=notes>The combination of atrophy and gastritis helps the clinician to potentially make a diagnosis of atrophic gastritis.</ref> | File:Histopathology of antral mucosa with atrophy.png|In '''intestinal metaplasia''' (seen at bottom of this antral mucosa), also look for '''atrophy''' as pictured.<ref name=Carrasco/><ref group=notes>The combination of atrophy and gastritis helps the clinician to potentially make a diagnosis of atrophic gastritis.</ref> | ||
File:Histopathology of fundic mucosa with atrophy.png|Extensive atrophy of oxyntic glands in fundus/corpus causes '''pseudo-pyloric metaplasia'''.<ref name=Carrasco/> | File:Histopathology of fundic mucosa with atrophy.png|Extensive atrophy of oxyntic glands in fundus/corpus causes '''pseudo-pyloric metaplasia'''.<ref name=Carrasco/> | ||
Revision as of 12:27, 20 September 2021
Author:
Mikael Häggström [note 1]
Inflammation of the stomach:
Microscopy evaluation
- Mild acute gastritis:[2]
- 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.[1]
![Early acute superficial gastritis: Marked neutrophilic infiltrates appear in the mucous neck region and lamina with a pit micoabscess.[1]](/index.php?title=Special:Upload&wpDestFile=Histopathology_of_early_acute_superficial_gastritis.png){kind=link}
- Moderate to severe acute gastritis:[2]
- Loss of superficial epithelium above the muscularis mucosa
- Hemorrhage
- Variable infiltrate with neutrophils
- Fibrinopurulent luminal exudate
- Nearby epithelium may show regenerative changes
- Chronic gastritis[3]
- 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.
-
Extensive atrophy of oxyntic glands in fundus/corpus causes pseudo-pyloric metaplasia.[1]
![In intestinal metaplasia (seen at bottom of this antral mucosa), also look for atrophy as pictured.[1][notes 1]](/index.php?title=Special:Upload&wpDestFile=Histopathology_of_antral_mucosa_with_atrophy.png){kind=link}
![Extensive atrophy of oxyntic glands in fundus/corpus causes pseudo-pyloric metaplasia.[1]](/index.php?title=Special:Upload&wpDestFile=Histopathology_of_fundic_mucosa_with_atrophy.png){kind=link}
When gastritis is present, also evaluate as a stomach biopsy for Helicobacter pylori.
Microscopy report
Chronic gastritis without neutrophils is preferably also termed "non-active".
Example:
| (Gastric, biopsy:) Mild chronic non-active gastritis, non-specific. Negative for Helicobacter pylori organisms on H&E slide. |
Notes
- ↑ The combination of atrophy and gastritis helps the clinician to potentially make a diagnosis of atrophic gastritis.
- ↑ 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.
Main page
References
- ↑ 1.0 1.1 1.2 1.3 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 - ↑ 2.0 2.1 Elliot Weisenberg. Stomach - Gastritis - Acute gastritis. pathologyOutlines. Topic Completed: 1 August 2012. Minor changes: 31 August 2020
- ↑ Elliot Weisenberg. Stomach - Gastritis - Chronic gastritis. PathologyOutlines. Topic Completed: 1 August 2012. Minor changes: 31 August 2020
Image sources