Difference between revisions of "Eosinophilic gastritis"

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{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Stomach_with_eosinophilia_-_2_--_high_mag.jpg
| Width      =
| Caption    = Stomach with eosinophilia. [[H&E stain]].
| Synonyms  =
| Micro      = abundant eosinophils (>=127 eosinophils/mm<sup>2</sup>)
| Subtypes  =
| LMDDx      = [[chronic gastritis]], [[Helicobacter gastritis]], [[Crohn's disease]] - see ''[[inflammatory bowel disease and the stomach]]'', eosinophilic myeloproliferative neoplasm, eosinophilic gastroenteritis
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[stomach]]
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  = +/-abdominal pain
| Prevalence = very rare
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = benign?
| Other      =
| ClinDDx    = other causes of [[gastritis]]
| Tx        =
}}
'''Eosinophilic gastritis''', abbreviated '''EG''', is an uncommon inflammatory process of [[stomach]] characterized by abundant [[eosinophil]]s.
'''Eosinophilic gastritis''', abbreviated '''EG''', is an uncommon inflammatory process of [[stomach]] characterized by abundant [[eosinophil]]s.


===General===
==General==
*Rare.
*Rare.


===Gross===
Clinical:
*Abdominal pain.<ref name=pmid18693615>{{Cite journal  | last1 = Ayyub | first1 = M. | last2 = Almenawi | first2 = L. | last3 = Mogharbel | first3 = MH. | title = Eosinophilic gastritis; an unusual and overlooked cause of chronic abdominal pain. | journal = J Ayub Med Coll Abbottabad | volume = 19 | issue = 4 | pages = 127-30 | month =  | year =  | doi =  | PMID = 18693615 }}</ref>
*May mimic a gastric tumour.<ref name=pmid20501003>{{Cite journal  | last1 = Holroyd | first1 = DJ. | last2 = Banerjee | first2 = S. | last3 = Chaudhary | first3 = KS. | last4 = Reshamwalla | first4 = S. | last5 = Vijay | first5 = V. | last6 = Ward | first6 = MW. | title = Transmural eosinophilic gastritis with gastric outlet obstruction: case report and review of the literature. | journal = Ann R Coll Surg Engl | volume = 92 | issue = 4 | pages = W18-20 | month = May | year = 2010 | doi = 10.1308/147870810X12659688851915 | PMID = 20501003 }}</ref>
 
==Gross==
*+/-[[Gastric snakeskin appearance|Snakeskin appearance]].
*+/-[[Gastric snakeskin appearance|Snakeskin appearance]].


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*[[Portal hypertensive gastropathy]].
*[[Portal hypertensive gastropathy]].


===Microscopic===
==Microscopic==
Features:
Features:
*Abundant [[eosinophil]]s -- >=127 eosinophils/mm<sup>2</sup>.<ref name=pmid21169993/>
*Abundant [[eosinophil]]s -- >=127 eosinophils/mm<sup>2</sup>.<ref name=pmid21169993/>
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**[[Crohn's disease]] ~ 31 eosinophils/mm<sup>2</sup> (range: 0-203 eosinophils/mm<sup>2</sup>).
**[[Crohn's disease]] ~ 31 eosinophils/mm<sup>2</sup> (range: 0-203 eosinophils/mm<sup>2</sup>).
**[[Helicobacter gastritis]] ~ 25 eosinophils/mm<sup>2</sup> (range: 0-219 eosinophils/mm<sup>2</sup>).
**[[Helicobacter gastritis]] ~ 25 eosinophils/mm<sup>2</sup> (range: 0-219 eosinophils/mm<sup>2</sup>).
DDx:
*[[Chronic gastritis]].
*[[Helicobacter gastritis]].
*[[Crohn's disease]] - see ''[[inflammatory bowel disease and the stomach]]''.
*Eosinophilic myeloproliferative neoplasm.
*Eosinophilic gastroenteritis.
*[[Inflammatory fibroid polyp]] - spindle cells.
==Sign out==
===Focal eosinophilia===
<pre>
STOMACH, BIOPSY:
- BODY AND ANTRAL-TYPE GASTRIC MUCOSA WITH MODERATE CHRONIC ACTIVE INFLAMMATION AND
  FOCAL EOSINOPHILIA.
- NEGATIVE FOR HELICOBACTOR-LIKE ORGANISMS.
- NEGATIVE FOR INTESTINAL METAPLASIA.
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY.
COMMENT:
One of four tissue fragments has eosinophilia, with 45 eosinophils/1 HPF (where 1 HPF
is 0.2376 mm*mm).
</pre>


==See also==
==See also==
*[[Stomach]].
*[[Stomach]].
*[[Eosinophil]].
*[[Eosinophilic colitis]].
*[[Eosinophilic colitis]].
*[[Eosinophilic esophagitis]].
*[[Eosinophilic esophagitis]].

Latest revision as of 02:22, 7 March 2014

Eosinophilic gastritis
Diagnosis in short

Stomach with eosinophilia. H&E stain.

LM abundant eosinophils (>=127 eosinophils/mm2)
LM DDx chronic gastritis, Helicobacter gastritis, Crohn's disease - see inflammatory bowel disease and the stomach, eosinophilic myeloproliferative neoplasm, eosinophilic gastroenteritis
Site stomach

Symptoms +/-abdominal pain
Prevalence very rare
Prognosis benign?
Clin. DDx other causes of gastritis

Eosinophilic gastritis, abbreviated EG, is an uncommon inflammatory process of stomach characterized by abundant eosinophils.

General

  • Rare.

Clinical:

  • Abdominal pain.[1]
  • May mimic a gastric tumour.[2]

Gross

DDx:

Microscopic

Features:

  • Abundant eosinophils -- >=127 eosinophils/mm2.[3]
    • 30 eosinophils/HPF, if the field diameter of 1 HPF is 0.55 mm.

Notes:

  • Normal range:[3]
    • <38 eosinophils/mm2.
      • Typically ~16 eosinophils/mm2.
  • Mild eosinophilia is seen in:[3]

DDx:

Sign out

Focal eosinophilia

STOMACH, BIOPSY:
- BODY AND ANTRAL-TYPE GASTRIC MUCOSA WITH MODERATE CHRONIC ACTIVE INFLAMMATION AND
  FOCAL EOSINOPHILIA.
- NEGATIVE FOR HELICOBACTOR-LIKE ORGANISMS.
- NEGATIVE FOR INTESTINAL METAPLASIA.
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY.

COMMENT:
One of four tissue fragments has eosinophilia, with 45 eosinophils/1 HPF (where 1 HPF 
is 0.2376 mm*mm).

See also

References

  1. Ayyub, M.; Almenawi, L.; Mogharbel, MH.. "Eosinophilic gastritis; an unusual and overlooked cause of chronic abdominal pain.". J Ayub Med Coll Abbottabad 19 (4): 127-30. PMID 18693615.
  2. Holroyd, DJ.; Banerjee, S.; Chaudhary, KS.; Reshamwalla, S.; Vijay, V.; Ward, MW. (May 2010). "Transmural eosinophilic gastritis with gastric outlet obstruction: case report and review of the literature.". Ann R Coll Surg Engl 92 (4): W18-20. doi:10.1308/147870810X12659688851915. PMID 20501003.
  3. 3.0 3.1 3.2 Lwin, T.; Melton, SD.; Genta, RM. (Apr 2011). "Eosinophilic gastritis: histopathological characterization and quantification of the normal gastric eosinophil content.". Mod Pathol 24 (4): 556-63. doi:10.1038/modpathol.2010.221. PMID 21169993.