Neutrophils , antrum Most common cause for
plasma cells, chronic gastritis ->
Other risk factors Spiral shaped or carved rod
lymphoid e
Smoking e
aggregates >
Alcohol ·
NSAIDs, steroids Transmission - feco-oral
Cocaine route
Psychological stress Associated with poverty and
>
Zollinger - Ellison syndrome !$}@}@· Inflammation > Helicobacter pylori overcrowding
Endocrine cell hyperplasia &
COPD
* Acquired in childhood → colonization
in!) rate increases with the age
Peptic, duodenal
-
⑤
ulcers Chronic gastritis MALT
lymphomas it!*$@° Concentrate within
First part of duodenum-Peptic ulcers surface mucus
are four times more common in the a
D
proximal duodenum than in the e Atrophic Gastritis N
Etiology
stomach.
• Chronic infection by Helicobacter Easily seen with
Lesser curvature of stomach - near -
⑰ pylori special stains
interface of body and antrum
Intestinal metaplasia • Autoimmune (immunologic)
• Toxins - alcohol, smoking
it
• Radiation ga i
• Chronic bile reflux (after
Complications ↑ Dysplasia Warthin-Starry
gastroenterostomy) Giemsa
Bleeding • Radiation silver stain
• Perforation ⑱ • Mechanical
• Obstruction - due to edema or scarring
• Malignant transformation - very rare Gastric
adenocarcinoma
-
Morphology -
H-pylori - antrum '
Autoimmune -Body and fundus
!
-
Microscopy Macroscopy
There are four zones Shallow or deep, size is variable ( mm to cm)
• Round to oval, sharply punched- out lesion with relatively straight
me
1. Superficial thin layer of necrotic debris and fibrin.
2. Beneath this zone there are inflammatory cells walls. In contrast
heaped up
predominantly consisting of neutrophils. • Mucosal margin may overhang the base.
• Base is smooth and clean (due to peptic digestion). marging
in
malignant ulars
3. Granulation tissue in the deeper layers.
4. Collagenous/ fibrous scar • Later there is scarring and puckering of the surrounding mucosa
( with mucosal folds that radiate from the crater).