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Histopathological features in acute gastritis:
Mild form:
Edema in lamina propria; Slight hyperemia in the interfoveolar area ;
Surface epithelium is intact ; Scattered neutrophils within mucosal
epithelial cells - this signifies active inflammation.
Acute
erosive/hemorrhagic gastritis:
-With more severe mucosal damage, erosion and hemorrhage develops.
[Erosion is defined as loss of superficial epithelium causing a defect
in the mucosa that does not cross the muscularis mucosa.]
-Lesion is acccompanied by a dense acute inflammatory infiltrate and
extrusion of fibrin, containing purulent exudate into the lumen.
-Deep mucosa (glandular zone) is usually unaffected unless stress
ulcer results due to local necrosis.
-Crypts may be dilated & filled with acute inflammatory cells in
erosive gastritis.
Healing phase:
Epithelial
regeneration ; Elongation of pit ; Pseudostratified appearance of
superficial epithelium ;Residual cluster of neurtrophils in the pit ;
Residual cluster of neutrophils in the pit.
Note: Pathologists should be
careful not to diagnose regenerative changes as malignancy.
Regenerative changes include:
Regular glands arranged parallel to one another ; Lamina propria
separating the glands ;
Basally located nucleii ; Basophilic cytoplasm ; Increased nuclear
cytoplasmic ratio ;
Increased mitotic activity.
Summary of histological
features:
-Hyperemia
-Surface erosion
-Acute inflammation
-Massive mucosal necrosis
-Sloughing
-Eventual scarring |
