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Difference between revisions of "Intestinal metaplasia of the stomach"
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Intestinal metaplasia of the stomach (view source)
Revision as of 12:56, 3 May 2016
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{{ Infobox diagnosis | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | | Name = {{PAGENAME}} | ||
| Image = | | Image = Stomach with intestinal metaplasia -- intermed mag.jpg | ||
| Width = | | Width = | ||
| Caption = Intestinal metaplasia of the stomach. [[H&E stain]]. | | Caption = Intestinal metaplasia of the stomach. [[H&E stain]]. | ||
| Micro = | | Micro = goblet cells with foveolar epithelium | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = contaminant from the [[duodenum]] | | LMDDx = contaminant from the [[duodenum]], [[gastric dysplasia]], [[gastric carcinoma]], [[gastric heterotopia of the duodenum]] | ||
| Stains = | | Stains = alcian blue/PAS +ve | ||
| IHC = | | IHC = CDX2 +ve | ||
| EM = | | EM = | ||
| Molecular = | | Molecular = | ||
| Line 14: | Line 14: | ||
| Gross = | | Gross = | ||
| Grossing = | | Grossing = | ||
| Site = | | Site = [[stomach]] | ||
| Assdx = [[gastric carcinoma]], [[chronic gastritis]] | | Assdx = [[gastric carcinoma]], [[chronic gastritis]], [[Helicobacter gastritis]] | ||
| Syndromes = | | Syndromes = | ||
| Clinicalhx = | | Clinicalhx = +/-[[chronic gastritis]] | ||
| Signs = | | Signs = | ||
| Symptoms = | | Symptoms = | ||
| Line 23: | Line 23: | ||
| Bloodwork = | | Bloodwork = | ||
| Rads = | | Rads = | ||
| Endoscopy = | | Endoscopy = +/-erythema | ||
| Prognosis = | | Prognosis = | ||
| Other = | | Other = | ||
| ClinDDx = [[chronic gastritis|gastritis]] | | ClinDDx = [[chronic gastritis|gastritis]], [[gastric dysplasia]] | ||
}} | }} | ||
'''Intestinal metaplasia of the stomach''' is a relative common finding that is associated with modest increased risk of [[gastric carcinoma]]. | {{ Infobox external links | ||
| Name = {{PAGENAME}} | |||
| EHVSC = | |||
| EHVSC_mult = {{EHVSC3|10167|focal}} | |||
| pathprotocols = | |||
| wikipedia = | |||
| pathoutlines = | |||
}} | |||
'''Intestinal metaplasia of the stomach''' is a relative common finding that is associated with a modest increased risk of [[gastric carcinoma]]. | |||
It is also known as '''gastric [[intestinal metaplasia]]''' and may be abbreviated '''IM'''. | It is also known as '''gastric [[intestinal metaplasia]]''' and may be abbreviated '''IM'''. | ||
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DDx: | DDx: | ||
*[[Normal duodenum|Normal small bowel mucosa]] - no foveolar epithelium present. | *[[Normal duodenum|Normal small bowel mucosa]] - no foveolar epithelium present, possibly a contaminant from a concurrent duodenal biopsy. | ||
*[[Gastric dysplasia]], intestinal type. | *[[Gastric dysplasia]], intestinal type. | ||
*[[Gastric heterotopia of the duodenum]]. | |||
Image: | ===Images=== | ||
<gallery> | |||
Image: Stomach with intestinal metaplasia -- intermed mag.jpg | Stomach IM - intermed. mag. (WC) | |||
Image: Stomach with intestinal metaplasia -- high mag.jpg | Stomach IM - high mag. (WC) | |||
</gallery> | |||
==Stains== | ==Stains== | ||
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*Alican blue stain +ve.{{fact}} | *Alican blue stain +ve.{{fact}} | ||
Image | ===Image=== | ||
<gallery> | |||
Image:Barrett%27s_mucosa,_Alcian_blue_stain.jpg | Barrett's mucosa - Alcian blue stain. (WC) | |||
</gallery> | |||
==IHC== | ==IHC== | ||
*CDX2 +ve (-ve in normal stomach).<ref name=pmid12477745 | *CDX2 +ve (-ve in normal stomach).<ref name=pmid12477745/> | ||
**Strong assoc. with ''[[Helicobacter gastritis]]'' as well as IM.<ref name=pmid12047325>{{Cite journal | last1 = Satoh | first1 = K. | last2 = Mutoh | first2 = H. | last3 = Eda | first3 = A. | last4 = Yanaka | first4 = I. | last5 = Osawa | first5 = H. | last6 = Honda | first6 = S. | last7 = Kawata | first7 = H. | last8 = Kihira | first8 = K. | last9 = Sugano | first9 = K. | title = Aberrant expression of CDX2 in the gastric mucosa with and without intestinal metaplasia: effect of eradication of Helicobacter pylori. | journal = Helicobacter | volume = 7 | issue = 3 | pages = 192-8 | month = Jun | year = 2002 | doi = | PMID = 12047325 }}</ref> | **Strong assoc. with ''[[Helicobacter gastritis]]'' as well as IM.<ref name=pmid12047325>{{Cite journal | last1 = Satoh | first1 = K. | last2 = Mutoh | first2 = H. | last3 = Eda | first3 = A. | last4 = Yanaka | first4 = I. | last5 = Osawa | first5 = H. | last6 = Honda | first6 = S. | last7 = Kawata | first7 = H. | last8 = Kihira | first8 = K. | last9 = Sugano | first9 = K. | title = Aberrant expression of CDX2 in the gastric mucosa with and without intestinal metaplasia: effect of eradication of Helicobacter pylori. | journal = Helicobacter | volume = 7 | issue = 3 | pages = 192-8 | month = Jun | year = 2002 | doi = | PMID = 12047325 }}</ref> | ||
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==Sign out== | ==Sign out== | ||
===Focal=== | |||
<pre> | |||
Stomach, Antrum, Biopsy: | |||
- Antral-type gastric mucosa with intestinal metaplasia (focal) and | |||
moderate chronic inactive inflammation. | |||
- NEGATIVE for Helicobacter-like organisms. | |||
- NEGATIVE for dysplasia and NEGATIVE for malignancy. | |||
</pre> | |||
====Block letters==== | |||
<pre> | <pre> | ||
STOMACH, BIOPSY: | STOMACH, BIOPSY: | ||
- BODY-TYPE MUCOSA WITH INTESTINAL METAPLASIA, FOCAL. | - BODY-TYPE GASTRIC MUCOSA WITH INTESTINAL METAPLASIA, FOCAL. | ||
- MINIMAL CHRONIC GASTRITIS (BODY OF STOMACH). | - MINIMAL CHRONIC GASTRITIS (BODY OF STOMACH). | ||
- NEGATIVE FOR HELICOBACTER-LIKE ORGANISMS. | - NEGATIVE FOR HELICOBACTER-LIKE ORGANISMS. | ||
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<pre> | <pre> | ||
STOMACH, BIOPSY: | STOMACH, BIOPSY: | ||
- ANTRAL-TYPE MUCOSA WITH INTESTINAL METAPLASIA | - ANTRAL-TYPE GASTRIC MUCOSA WITH FOCAL INTESTINAL METAPLASIA AND MILD CHRONIC | ||
INACTIVE INFLAMMATION. | |||
- NEGATIVE FOR HELICOBACTER-LIKE ORGANISMS. | - NEGATIVE FOR HELICOBACTER-LIKE ORGANISMS. | ||
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | - NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | ||
</pre> | </pre> | ||
===Extensive=== | |||
<pre> | <pre> | ||
STOMACH, BIOPSY: | STOMACH, BIOPSY: | ||
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*[[Stomach]]. | *[[Stomach]]. | ||
*[[Duodenum]]. | *[[Duodenum]]. | ||
*[[Intestinal metaplasia of the esophagus]]. | |||
*[[Intestinal metaplasia]]. | |||
==References== | ==References== | ||