GASTROENTEROLOGY ARTICLE OF THE WEEK
August 31, 2006
McKenna BJ, Appleman HD. Primer: histopathology for the clinician – how to interpret biopsy information for gastritis. Gastroenterol Hepatol 2006;3:165-171.
1. Lymphocytic gastritis can be seen in association with all of the following except:
a. celiac sprue
b. Menetrier’s disease
c. NSAID use
d. H. pylori infection
2. Autoimmune atrophic gastritis
a. is always associated with pernicious anemia
b. findings are most prominent in the fundus and body
c. when established, it is associated with complete loss of parietal cells
d. is associated with enterochromaffin-like cell hyperplasia and even carcinoid
e. causes hypergastrinemia and excessive acid production
True or False
3. “Gastritis” noted on endoscopic exam usually correlates with histologic evidence of inflammation.
4. The inflammatory infiltrate in H. pylori gastritis is mostly neutrophilic, lymphocytosis is very rare
5. Atrophic gastritis of the antrum is a type of autoimmune gastritis.
6. When autoimmune gastritis is suspected, biopsies from the fundus and body should be obtained and properly labeled
7. Bile reflux gastritis is associated with very little to no inflammation on biopsy.
8. NSAID-associated gastritis is classified as a chemical gastropathy, histologically demonstrating foveolar hyperplasia, decreased mucus production, smooth muscle fiber infiltration and little to no inflammation.
9. A truly normal gastric mucosa should have no inflammatory cells at all
10. Recently or partially treated H. pylori may produce a gastric biopsy with lymphocyte predominance, very few to non neutrophils and no visible H. pylori organisms