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Surgical-Pathology.com
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What is a
precancerous condition? Precancerus condition is a clinical state
associated with increased risk of cancer. Example: 1. Atrophic gastritis with intestinal metaplasia, 2. Pernicious anaemia 3. Gastric stump 4. Certain types of gastric polyps What is a precancerous lesion? Precancerous lesion is a histopathological abnormality in which cancer is more likely to occur. Example: Gastric dysplasia. |
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While diagnosing a
case of gastric dysplasia the histopathologist must consider the
following: 1. Whether the biopsy origiate from an adenoma or flat gastric mucosa. 2. Whether the biopsy is from the margin of a carcinoma 3. Whether there is carcinoma elsewhere. 4. Whether the lesion is part of a wider mucosal abnormality. |
Gastric dysplasia may present as a raised, circumscribed lesion (adenoma) or as a flat/depressed lesion. Adenomatous
dysplasia : Gastric
epithelial dysplasia(flat/depressed) :
- Gross
features: Ill-defined thickened and congested mucosa which may be
slightly depressed or
- Microscopic
features:
Classification of gastrointestinal epithelial neoplasia:
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Differential diagnosis of gastric dysplasia: 1.Reactive epithelial hyperplasia (gastritis, erosion or ulceration). Enlarged pleomorphic nuclei that show homogeneous basophilia and are basally orientated. Prominent but small and uniform nucleoli. Surface maturation is present. Gradual transition with adjacent epithelium Atypical glands embedded in granulation tissue ,fibrin and ulcer slough ( useful clue ). Note : Histopathologist should be very careful while making a diagnosis of high grade dysplasia in the presence of large numbers of intraepithelial neutrophils. 2. Reflux gastritis: 3. Epithelial atypia associated with irradiation or antineoplastic chemotherapy - Present in specialized (deeper part ) mucosa. - Stromal cells affected. - No architectural abnormality. - No increase in mitotic activity. |
Images
High & low power view of high grade gastric dysplasia:
Created by:
Dr Sampurna Roy
MD
Site provides information on a wide range of
Non-Neoplastic and Neoplastic Gastric Lesions.
