Difference between revisions of "Autoimmune metaplastic atrophic gastritis"
Jump to navigation
Jump to search
(tweak) |
|||
| Line 6: | Line 6: | ||
| Micro = corpus predominant inflammation - usu. moderate or severe, loss of parietal cells, increased G cells in the antrum | | Micro = corpus predominant inflammation - usu. moderate or severe, loss of parietal cells, increased G cells in the antrum | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = [[chronic gastritis]], [[intestinal metaplasia of the stomach]] | | LMDDx = [[chronic gastritis]], [[intestinal metaplasia of the stomach]], [[gastric neuroendocrine tumour]] | ||
| Stains = | | Stains = | ||
| IHC = | | IHC = | ||
| Line 21: | Line 21: | ||
| Symptoms = | | Symptoms = | ||
| Prevalence = uncommon | | Prevalence = uncommon | ||
| Bloodwork = antibodies to parietal cells | | Bloodwork = antibodies to parietal cells & intrinsic factor, [[macrocytic anemia]], increased gastrin level | ||
| Rads = | | Rads = | ||
| Endoscopy = erythema - corpus only | | Endoscopy = erythema - corpus only | ||
Revision as of 02:13, 28 September 2013
| Autoimmune metaplastic atrophic gastritis | |
|---|---|
| Diagnosis in short | |
|
| |
| LM | corpus predominant inflammation - usu. moderate or severe, loss of parietal cells, increased G cells in the antrum |
| LM DDx | chronic gastritis, intestinal metaplasia of the stomach, gastric neuroendocrine tumour |
| Site | stomach |
|
| |
| Prevalence | uncommon |
| Blood work | antibodies to parietal cells & intrinsic factor, macrocytic anemia, increased gastrin level |
| Endoscopy | erythema - corpus only |
| Clin. DDx | diffuse chronic gastritis |
Autoimmune metaplastic atrophic gastritis, also autoimmune gastritis[1] is a rare pathology of the stomach. It is closely associated with pernicious anemia.
General
- Pathology: loss of parietal cells, gastric atrophy, macrocytic anemia.
- Etiology: autoimmune.
Diagnosis based on serology for antibodies to:[2]
- Parietal cells.
- Intrinsic factor.
Others:
Note:
- Parietal cells produce intrinsic factor (important for vitamin B12 absorption) and hydrogen chloride, i.e. stomach acid.
Gross
- Erythema - corpus involved, antrum spared.
Microscopic
Features:
- Corpus predominant inflammation - usu. moderate or severe - key feature.
- Loss of parietal cells.
- Increased G cells in the antrum.
- Produce gastrin to stimulate the (missing) parietal cells.
Notes:
- Compare with other types of gastric atrophy.
DDx:
IHC
Features:[5]
- Chromogranin A +ve (demonstrates nodular enterochromaffin-like cell hyperplasia).
- Gastrin -ve (body of stomach).
- +ve in antrum.
Images:
- Autoimmune gastritis - chromogranin A (nih.gov).[6]
- Findings may be seen in hypergastrinemia and nodular enterochromaffin cell-like (ECL) hyperplasia.
Sign out
STOMACH, BIOPSY: - SEVERE CHRONIC ACTIVE GASTRITIS WITH EXTENSIVE INTESTINAL METAPLASIA. - NEGATIVE FOR HELICOBACTER-LIKE ORGANISMS. - NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. COMMENT: Parietal cells are not apparent on the H&E stained sections. Immunostains show rows of Chromogranin A positive cells and a lack of gastrin staining. These findings suggest an autoimmune gastritis; correlation with blood work is suggested.
See also
References
- ↑ Chlumská, A.; Boudová, L.; Benes, Z.; Zámecník, M. (Oct 2005). "Autoimmune gastritis. A clinicopathologic study of 25 cases.". Cesk Patol 41 (4): 137-42. PMID 16382988.
- ↑ Oh, R.; Brown, DL. (Mar 2003). "Vitamin B12 deficiency.". Am Fam Physician 67 (5): 979-86. PMID 12643357.
- ↑ Annibale, B.; Lahner, E.; Fave, GD. (Dec 2011). "Diagnosis and management of pernicious anemia.". Curr Gastroenterol Rep 13 (6): 518-24. doi:10.1007/s11894-011-0225-5. PMID 21947876.
- ↑ URL: http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/8512. Accessed on: 14 August 2012.
- ↑ Park, JY.; Cornish, TC.; Lam-Himlin, D.; Shi, C.; Montgomery, E. (Nov 2010). "Gastric lesions in patients with autoimmune metaplastic atrophic gastritis (AMAG) in a tertiary care setting.". Am J Surg Pathol 34 (11): 1591-8. doi:10.1097/PAS.0b013e3181f623af. PMID 20975338.
- ↑ Pritchard, DM.; Berry, D.; Przemeck, SM.; Campbell, F.; Edwards, SW.; Varro, A. (Oct 2008). "Gastrin increases mcl-1 expression in type I gastric carcinoid tumors and a gastric epithelial cell line that expresses the CCK-2 receptor.". Am J Physiol Gastrointest Liver Physiol 295 (4): G798-805. doi:10.1152/ajpgi.00015.2008. PMID 18719002.