Difference between revisions of "Gastric antral vascular ectasia"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Gastric_antral_vascular_ectasia_-_very_high_mag.jpg | |||
| Width = | |||
| Caption = Gastric antral vascular ectasia. [[H&E stain]]. | |||
| Micro = fibrin thrombi (characteristic feature), dilated capillaries in lamina propria, +/-foveollar hyperplasia | |||
| Subtypes = | |||
| LMDDx = [[portal hypertensive gastropathy]] | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[stomach]] | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = 60s or 70s, females:males >2:1 | |||
| Signs = +/- melena | |||
| Symptoms = | |||
| Prevalence = uncommon | |||
| Bloodwork = usu. [[anemia]] | |||
| Rads = | |||
| Endoscopy = linear red streaks in antrum - watermelon-like | |||
| Prognosis = | |||
| Other = | |||
| ClinDDx = | |||
}} | |||
{{ Infobox external links | |||
| Name = {{PAGENAME}} | |||
| EHVSC = | |||
| EHVSC_mult = | |||
| pathprotocols = | |||
| wikipedia = gastric antral vascular ectasia | |||
| pathoutlines = | |||
}} | |||
'''Gastric antral vascular ectasia''', abbreviated '''GAVE''', is an uncommon pathology of the [[stomach]]. It is also known as '''watermelon stomach''' due to characteristic endoscopic appearance.<ref name=pmid18625989>{{cite journal |author=Chatterjee S |title=Watermelon stomach |journal=CMAJ |volume=179 |issue=2 |pages=162 |year=2008 |month=July |pmid=18625989 |pmc=2443230 |doi=10.1503/cmaj.080461 |url=http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=18625989}}</ref> | |||
==General== | |||
*Etiology not well understood.<ref name=pmid20011731/> | |||
*Typically presents with gastrointestinal bleeding or [[anemia]]. | |||
*Age - usually 60s or 70s. | |||
*Females:males >2:1.<ref name=pmid20011731>{{Cite journal | last1 = Rosenfeld | first1 = G. | last2 = Enns | first2 = R. | title = Argon photocoagulation in the treatment of gastric antral vascular ectasia and radiation proctitis. | journal = Can J Gastroenterol | volume = 23 | issue = 12 | pages = 801-4 | month = Dec | year = 2009 | doi = | PMID = 20011731 | PMC = 2805515 }}</ref> | |||
==Gross/endoscopic appearance== | |||
* Linear red streaks in antrum - streaks oriented toward the pyloric valve... vaguely resembles a watermelon. | |||
===Endoscopic images=== | |||
<gallery> | |||
Image:Gastric antral vascular ectasia (before and after).png |GAVE - before and after treatment. (WC) | |||
</gallery> | |||
www: | |||
*[http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2443230&rendertype=figure&id=f1-19 Watermelon stomach (pubmedcentral.nih.gov)]. | |||
==Microscopic== | |||
Features:<ref name=Ref_GLP118>{{Ref GLP|118}}</ref> | |||
*Fibrin thrombi - '''characteristic feature'''. | |||
*Dilated capillaries in lamina propria - '''important feature'''. | |||
*+/-Foveollar hyperplasia.<ref name=Ref_GLP119>{{Ref GLP|119}}</ref> | |||
DDx: | |||
*[[Portal hypertensive gastropathy]] - predominantly in the gastric body, usu. associated with [[cirrhosis]], do not have fibrin thrombi.<ref name=Ref_GLP120-1>{{Ref GLP|120-1}}</ref> | |||
===Images=== | |||
<gallery> | |||
Image:Gastric_antral_vascular_ectasia_-_2_-_intermed_mag.jpg | GAVE - intermed. mag. (WC) | |||
Image:Gastric_antral_vascular_ectasia_-_2_-_very_high_mag.jpg | GAVE - very high mag. (WC) | |||
</gallery> | |||
<gallery> | |||
Image:Gastric antral vascular ectasia - low mag.jpg | GAVE - low mag. (WC) | |||
Image:Gastric antral vascular ectasia - intermed mag.jpg | GAVE - intermed. mag. (WC) | |||
Image:Gastric antral vascular ectasia - high mag.jpg | GAVE - high mag. (WC) | |||
Image:Gastric_antral_vascular_ectasia_-_very_high_mag.jpg | GAVE - two thrombi - very high mag. (WC) | |||
</gallery> | |||
==Sign out== | |||
<pre> | |||
STOMACH, BIOPSY: | |||
- GASTRIC ANTRAL VASCULAR ECTASIA WITH FOVEOLAR HYPERPLASIA. | |||
- MILD CHRONIC ACTIVE ANTRAL GASTRITIS. | |||
- NEGATIVE FOR INTESTINAL METAPLASIA. | |||
- NEGATIVE FOR DYSPLASIA. | |||
- NEGATIVE FOR HELICOBACTER ORGANISMS. | |||
</pre> | |||
===Micro=== | |||
The sections show antral-type gastric mucosa with dilated lamina propria blood vessels and intravascular fibrin thrombi. There is mild foveolar hyperplasia. Numerous neutrophils are present between the foveollar cells and within the lamina propria. Several large clusters of plasma cells are present in the lamina propria. | |||
==See also== | |||
*[[Stomach]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Stomach]] | |||
[[Category:Gastrointestinal pathology]] | |||
Latest revision as of 17:56, 18 August 2013
Gastric antral vascular ectasia, abbreviated GAVE, is an uncommon pathology of the stomach. It is also known as watermelon stomach due to characteristic endoscopic appearance.[1]
| Gastric antral vascular ectasia | |
|---|---|
| Diagnosis in short | |
 Gastric antral vascular ectasia. H&E stain. | |
|
| |
| LM | fibrin thrombi (characteristic feature), dilated capillaries in lamina propria, +/-foveollar hyperplasia |
| LM DDx | portal hypertensive gastropathy |
| Site | stomach |
|
| |
| Clinical history | 60s or 70s, females:males >2:1 |
| Signs | +/- melena |
| Prevalence | uncommon |
| Blood work | usu. anemia |
| Endoscopy | linear red streaks in antrum - watermelon-like |
| Gastric antral vascular ectasia | |
|---|---|
| External resources | |
| Wikipedia | gastric antral vascular ectasia |
General
Gross/endoscopic appearance
- Linear red streaks in antrum - streaks oriented toward the pyloric valve... vaguely resembles a watermelon.
Endoscopic images
GAVE - before and after treatment. (WC)
.png)
www:
Microscopic
Features:[3]
- Fibrin thrombi - characteristic feature.
- Dilated capillaries in lamina propria - important feature.
- +/-Foveollar hyperplasia.[4]
DDx:
- Portal hypertensive gastropathy - predominantly in the gastric body, usu. associated with cirrhosis, do not have fibrin thrombi.[5]
Images
GAVE - intermed. mag. (WC)
GAVE - very high mag. (WC)
GAVE - low mag. (WC)
GAVE - intermed. mag. (WC)
GAVE - high mag. (WC)
GAVE - two thrombi - very high mag. (WC)
Sign out
STOMACH, BIOPSY: - GASTRIC ANTRAL VASCULAR ECTASIA WITH FOVEOLAR HYPERPLASIA. - MILD CHRONIC ACTIVE ANTRAL GASTRITIS. - NEGATIVE FOR INTESTINAL METAPLASIA. - NEGATIVE FOR DYSPLASIA. - NEGATIVE FOR HELICOBACTER ORGANISMS.
Micro
The sections show antral-type gastric mucosa with dilated lamina propria blood vessels and intravascular fibrin thrombi. There is mild foveolar hyperplasia. Numerous neutrophils are present between the foveollar cells and within the lamina propria. Several large clusters of plasma cells are present in the lamina propria.
See also
References
- ↑ Chatterjee S (July 2008). "Watermelon stomach". CMAJ 179 (2): 162. doi:10.1503/cmaj.080461. PMC 2443230. PMID 18625989. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=18625989.
- ↑ 2.0 2.1 Rosenfeld, G.; Enns, R. (Dec 2009). "Argon photocoagulation in the treatment of gastric antral vascular ectasia and radiation proctitis.". Can J Gastroenterol 23 (12): 801-4. PMC 2805515. PMID 20011731. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2805515/.
- ↑ Iacobuzio-Donahue, Christine A.; Montgomery, Elizabeth A. (2005). Gastrointestinal and Liver Pathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 118. ISBN 978-0443066573.
- ↑ Iacobuzio-Donahue, Christine A.; Montgomery, Elizabeth A. (2005). Gastrointestinal and Liver Pathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 119. ISBN 978-0443066573.
- ↑ Iacobuzio-Donahue, Christine A.; Montgomery, Elizabeth A. (2005). Gastrointestinal and Liver Pathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 120-1. ISBN 978-0443066573.