Gastric antral vascular ectasia

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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

  • Etiology not well understood.[2]
  • Typically presents with gastrointestinal bleeding or anemia.
  • Age - usually 60s or 70s.
  • Females:males >2:1.[2]

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)

www:

Microscopic

Features:[3]

  • Fibrin thrombi - characteristic feature.
  • Dilated capillaries in lamina propria - important feature.
  • +/-Foveollar hyperplasia.[4]

DDx:

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)

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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

  1. ↑ 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. ↑ 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/.
  3. ↑ 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.
  4. ↑ 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.
  5. ↑ 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.
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