Lymphocytic Gastritis

www.histopathology-india.net/GIPath.htm

April 2007

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An outline of the anatomy and normal histology of the stomach for pathologists.

Reporting of gastric biopsies (non-neoplastic gastric lesions).

Pathology and pathogenesis of peptic ulcer.

Acute Gastritis

Chronic Gastritis

Helicobacter pylori associated(TypeB) Gastritis

Autoimmune Gastritis (Type A)

Reactive /Reflux/ Chemical Gastritis (Type C)

Lymphocytic Gastritis

Collagenous Gastritis

Granulomatous Gastritis

Eosinophilic Gastritis

Gastric Xanthoma/Xanthelasma

Other Non-Neoplastic Gastric Lesions

Benign tumour and tumour- like lesions

Gastric Lymphoma

Gastric Carcinoid Tumour

Gastrointestinal Stromal Tumour

Gastric Epithelial Dysplasia

Early Gastric Carcinoma

Gross Examination of the Gastrectomy Specimen

Drug related lesions of the gastrointestinal tract

Pathogens commonly affecting Small Intestine:

Cryptosporidium

Cytomegalovirus infection

Hookworm Infection

Mycobacterium Avium Intracellulare

Schistosomiasis

Whipple's disease

- Normal Histology of the Large Intestine

- Interpretation of Large Intestinal Biopsies

- Assessment of abnormalities -1 (lumen, surface epithelium, subepithelial zone)

- Assessment of abnormalities - 2 (crypt density , architecture and epithelium)

- Assessment of abnormalities - 3 (changes in the lamina propria,muscularis mucosae and submucosa)

Lymphocytic gastritis is associated with coeliac disease (specially antral prdominant gastritis) and non-coeliac small intestinal intraepithelial lymphocytosis with malabsorption.

- Lymphocytic gastritis is also associated with Helicobacter pylori infection (specially corpus predominant lymphocytic gastritis).

- Eradication of H. pylori plays an important role in the treatment of lymphocytic gastritis.

- In the severe form lymphocytic gastritis is diagnosed as varioliform gastritis.

Endoscopic features : Enlarged mucosal folds, multiple, discrete mucosal nodules or plaques with central umbilications , erosions or apthoid ulcers and surrounding hyperemia.

Microscopic features:

-Intraepithelial T cells (CD8 positive) in the surface and superficial pit epithelium.
-Intraepithelial lymphocytes are scattered rather than in clusters.
-The glands are spared. The pits have a corrugated dilated appearance.
-There should be atleast 25 lymphocytes/100 epithelial cells to make a diagnosis.
-The intraepithelial lymphocytes create a vacuolated or clear cell appearance (subnuclear region).

Differential diagnosis:

Pathologists should be able to distinguish lymphocytic gastritis from B-cell lymphoepithelial lesions seen in MALT lymphomas.    Visit: Gastric Lymphoma

          IMAGE LINK(Greeson) ;  CASE LINK (AFIP)

Abstracts:

Lymphocytic gastritis and protein losing gastropathy. Dig Liver Dis 2000 Jun-Jul; 32(5):422-5.

Varioliform gastritis: frequency and relationship with lymphocytic gastritis.Arq Gastroenterol. 2000 Jan-Mar;37(1):7-12.

The pattern of involvement of the gastric mucosa in lymphocytic gastritis is predictive of the presence of of duodenal pathology. J Clin Pathol 1999; 52: 815-819

Effects of Helicobacter pylori eradication on the natural history of lymphocytic gastritis. Gut 1999;45: 495-498.

Lymphocytic gastritis: association with etiology and topology. Am J Surg Pathol 1999;23: 153-158

Lymphocytic gastritis and coeliac disease: evidence of a positive association.J Clin Pathol 1998   Mar 51; (3): 207-10.

Lymphocytic gastritis: a study of its frequency and review of the literature. Arq Gastroenterol 1998 ;35 (1): 26-31

Lymphocytic gastritis and associated small bowel disease: a diffuse lymphocytic gastroenteropathy? J Clin Pathol 1995;48: 939-445

Lymphocytic gastritis, gastric adenocarcinoma, primary gastric lymphoma. J Clin Pathol 1994 Dec; 47(12): 1123-4

PULMONARY PATHOLOGY:
Congenital Cystic Adenomatoid Malformation ; Acute Respiratory Distress Syndrome ;Sarcoidosis ;Bronchiolitis ; Emphysema ; Bronchial Asthma ;Chronic Bronchitis Pulmonary Alveolar Proteinosis ; Lipid Pneumonia ; Pulmonary Hypertension ;Pulmonary edema ;Pulmonary Infection ; Pneumococcal Pneumonia ; Haemophilus influenza Infection;Klebsiella Pneumoniae ; Mycoplasma Pneumonia ; Pneumocystis Pneumonia ; Legionellosis ; Localized Fibrous Tumour of the Pleura ; Biphasic Epithelial/Mesenchymal Lung Tumours ; Pulmonary Carcinosarcoma ;Pulmonary Blastoma ; Large Cell Neuroendocrine tumour;

Pneumoconiosis ; Silicosis ; Asbestosis ; Coal Pneumoconiosis ; Talcosis.

Soft Tissue Pathology;
Myxoid Tumours of Soft Tissue ; Classification of Soft Tissue Tumour; Gross examination of soft tissue specimen ; A practical approach to histopathological reporting of soft tissue tumours ; Grading of soft tissue tumours ; Lipomatous tumours ;Neural tumours ; Myogenic tumours ;Vascular tumours ;Fibroblastic/Myofibroblastic tumours ; Myofibroblastic tumours ; Fibrohistiocytic tumours ; ChondroOsseous tumours ; Soft TissueTumours of Uncertain Differentiation ; Notochordal Tumour -Chordoma ;Extra-adrenal Paraganglioma ; Gastrointestinal Stromal Tumour ;

http://www.histopathology-india.net/EsophagealPathology.htm

NORMAL HISTOLOGY OF ESOPHAGUS

AN APPROACH TO THE REPORTING OF ESOPHAGEAL BIOPSIES

BARRETT'S ESOPHAGUS (INTESTINAL METAPLASIA DYSPLASIA & ADENOCARCINOMA)

BENIGN TUMOURS AND TUMOUR - LIKE CONDITIONS OF ESOPHAGUS

1. SQUAMOUS PAPILLOMA OF THE ESOPHAGUS

2. INFLAMMATORY FIBROID POLYP OF THE ESOPHAGUS

3. LEIOMYOMA OF THE ESOPHAGUS

4. GRANULAR CELL TUMOUR OF THE ESOPHAGUS

5. ESOPHAGEAL CYSTS

6. GLYCOGENIC ACANTHOSIS

7.FIBROVASCULAR POLYPS

REPORTING OF ESOPHAGEAL RESECTION SPECIMENS

SQUAMOUS EPITHELIAL DYSPLASIA INCLUDING SQUAMOUS CELL CARCINOMA IN-SITU OF THE ESOPHAGUS

SMALL CELL CARCINOMA OF THE ESOPHAGUS

DRUG RELATED LESIONS OF THE GASTROINTESTINAL TRACT

Normal histology of the small intestine for anatomic pathologists

An approach to evaluation of small intestinal biopsy.

Malabsorption syndrome (causes and clinical investigations)

Coeliac Disease

Enteropathy-associated T-cell lymphoma

Intestinal lymphangiectasia

Lesions causing small bowel obstruction and bleeding -
Intussusception : Adhesions : Volvulus

Meckel's diverticulum

Ischemic bowel disease

Brunner's Gland Adenoma

Duodenal Gangliocytic Paraganglioma

Lymphoma of the small intestine