Virtual Slidebox
Presented by the MGH Pathology Service

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

Read more on Autoimmune gastritis…

22 y/o female with stomach ache

55 y/o M with polyp

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

Read more on H. pylori gastritis, granulomatous…

Female in her 40’s with diarrhea, weight loss, early satiety. Stomach biopsy

Female in her 50’s with erosions in stomach. Stomach biopsy.

58 year old with 10 cm gastric polyp

MICROSCOPIC FEATURES

• Foveolar hyperplasia with mucin depletion
• “Corkscrewing” of gastric pits due to expansion of neck compartment
• Smooth muscle proliferation and vascular congestion in the lamina propria
• Little or no inflammation
• May lead to erosion and ulceration if severe
• Changes are restricted to the antrum

Read more on Reactive gastropathy…

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

Read more on Reactive gastropathy, due to iron supplements…