MICROSCOPIC FEATURES
• Marked lymphoplasmacytic infiltrate in the lamina propria, with associated damage of the fundic glands (“lymphoepithelial lesions”)
• Loss of oxyntic glands (parietal and chief cells) may result in “antralization” of body/fundus
• Metaplasia (pyloric, intestinal, and pancreatic) may be seen
• Affects body/fundus but spares the antrum (vs. atrophic gastritis)
• Changes can be variable depending on severity and duration of disease
MICROSCOPIC FEATURES
• Non-caseating epithelioid granulomas centered in portal tracts
• Lymphoplasmacytic “cuff” of inflammation surrounding granulomas
• Necrosis is uncommon, and tuberculomas are very rare
• Hepatic parenchyma is otherwise fairly normal in appearance
MICROSCOPIC FEATURES
• Non-caseating epithelioid granulomas in association with features of H. pylori gastritis (see below)
• Diffuse superficial chronic inflammation
• Neutrophils present at the neck region (“pititis”)
• Large lymphoid follicles may be present
• Regenerative epithelial changes with foveolar hyperplasia
MICROSCOPIC FEATURES
• Foveolar hyperplasia with mucin depletion
• “Corkscrewing” of gastric pits due to expansion of neck compartment
• Smooth muscle proliferation in the lamina propria
• Little or no inflammation
• Subepithelial iron crystals
• May lead to erosion and ulceration if severe
MICROSCOPIC FEATURES
• Numerous metaphase mitoses in crypt epithelium, especially “ring” mitoses
• There may also be epithelial pseudostratification, loss of goblet cell polarity, villus blunting, and increased apoptotic figures
DIFFERENTIAL DIAGNOSIS
8 y/o M with a tongue lesion
66 y/o F with a soft palate lesion
46 y/o F with lip lesions
40 y/o M with a right nasal cavity mass
37 y/o M with one month old painful 1.5 cm ventral tongue lesion. The patient has 1-2 cm palpable lymph nodes in the submandibular and left cervical regions.
History of HIV infection
73y/oF with a possible wart on right superonasal skin
27 y/o M with a nasal mass of 4-5 weeks
33 y/o M with a history of acute HA & ITP (Evans syndrome),who is s/p splenectomy, with IgA deficiency and lip lesion
65 y/o F with persistent periapical lucency around #28 following root canal treatment many years ago
36 yo male with h/o IDDM last A1C 14.9 as well as invasive mucormycosis
71 y/o F with a left posterior ethmoid mass
28 y/o F with deviated nasal septum and chronic sinusitis
62 y/o female with a left frontal tumor
47 y/o male with a history of seminoma, renal cell carcinoma, and sarcoma, now with a cavernous sinus mass
51 y/o male with a left occipital mass
62 y/o male with a cerebellar mass
36 y/o male with a mediastinal mass
30 y/o female with a frontal tumor
50 y/o male with a right cerebellar mass
68 y/o male with a right frontal lobe mass
22 y/o male with a left occipital lobe mass
65 y/o male with a left parietal mass
78 y/o male with a posterior fossa mass
Oil Red O stain – Demonstrates the presence of intracytoplasmic lipid in the tumor cells, supporting the diagnosis of hemangioblastoma.
71 y/o male with a right temporal mass
37 y/o female with a right parietal mass
48 y/o female with a parieto-occipital mass
55 y/o male with a history of ETOH abuse
63 y/o female with peritoneal nodules
57 y/o female with a history of endometriosis and a pelvic mass
38 y/o female with a history of osteosarcoma
68 y/o male with a pancreatic head mass
56 y/o female with a parotid mass
52 y/o female with a maxillary sinus mass
59 y/o male with a thyroid mass
68 y/o female with a pancreatic mass
70 y/o male with a history of bladder and prostate carcinoma, and sarcoma of the thigh.
46 y/o female with a uterine mass
29 y/o male with a mass extending from the left distal femur
39 y/o female with duodenal mass
26 y/o female with sellar mass
54 y/o female with cervical lymphadenopathy
57 y/o female with right temporal lobe mass
74 y/o female with left temporal lobe mass
68 y/o female with vision loss and non-enhancing frontal brain lesion on MRI