Chronic Gastritis

 

Epidemiology:

    • H. pylori
    • Autoimmune (some of atrophic gastritis)
      • Older white women mainly

 

Common sites:

    • Antrum for H. pylori
    • Body and fundus for autoimmune gastritis

 

Gross features:

    • erythematous mucosa with course texture
    • thickened rugae or thin, flattened surface

 

Histologic features:

    • chronic inflammatory infiltrate
    • neutrophils in epithelium signify active component
    • lymphoid aggregates in the mucosa
    • regenerative change (reactive):
      • increased mitotic figures in gland necks
      • enlarged, hyperchromatic nuclei in surface epithelial cells
      • reduced or absent mucous vacuoles in the surface epithelial cells
    • atrophic gastritis:
      • loss of fundic glands
        • may appear as antral mucosa, but gastrin stain is positive
      • cystic dilation of persisting glands
      • Intestinal metaplasia
      • Pyloric metaplasia
      • ECL cell hyperplasia
    • dysplasia

 

Immunophenotype:

Marker:

Sensitivity:

Specificity:

Modified Giemsa
(H. pylori)

 

 

 

 Other Features:

    • atrophic gastritis is a risk factor for dysplasia, adenocarcinoma, carcinoid
    •  

 

References:

    • The Washington Manual of Surgical Pahology 2nd ed. (2012)
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