The final diagnosis
of granulomatous gastritis is based on morphological findings and
detailed clinical history and laboratory data.
must provide the following clinical details to the pathologist -
History of immunosuppression, intake of drugs, past history of
tuberculosis, sarcoidosis, Crohn's etc.
Macrosopically there is thickening of the gastric wall (Differential
- Differential Diagnosis:
Infectious conditions: Tuberculosis, syphilis, histoplasmosis,
2. Associated with malignancies: Gastric carcinoma, lymphoma.
3. Foreign body granuloma: Food granuloma, suture granuloma .
4. Miscellaneous: Crohn's, sarcoidosis, chronic granulomatous disease
of childhood, allergic granulomatosis and vasculitis, Whipple's
Usually the antrum is affected.
Gross- Thickened wall, shallow ulcers.
Microscopically- Confluent caseating granuloma. Acid fast organisms are
Gross: Starts as erosive or ulcerative lesion.
In later stage the stomach is shrunken and fibrotic (leather-bottle).
Dense plasmacytic infiltrate;
Demonstration of spirochetes by silver stains.
Usually located in
the Gastric antrum.
In florid condition the following features may be present:
- Transmural inflammation
- Pit abscess
- Lymphoid aggregates and prominent lymphoid follicles.
- Sarcoid like granuloma
Multiple granulomas are observed in sarcoidosis, Whipple's disease
and vasculitis-associated cases.