Gastric ulcer

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Gastric ulcer, also stomach ulcer, is pathology of the stomach that is evident grossly. It can be benign or malignant.

General

  • May be benign or malignant.

Causes:

Gross

  • Heaped (raised) edges - suggestive of cancer.
  • Punched-out appearance with flat edges - suggestive of benign.

Notes:

  • The classical teaching is to biopsied the ulcer edge, as the dictum is: the cancer is there; this dictum may not be true.[2]

Images

Microscopic

Features:

  • Loss of the (gastric) epithelium.
  • Vital reaction.
    • Marked (acute) inflammation.
    • Fibrin.

Images

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Compatible with benign

A. STOMACH, BIOPSY:
- GASTRIC ANTRAL-TYPE MUCOSA WITH EDEMA, FOCALLY PROMINENT SMOOTH MUSCLE, 
  ACTIVATED FIBROBLASTS, A MILD INCREASE OF EOSINOPHILS, AND FIBRIN -- 
  COMPATIBLE WITH NEARBY ULCER.
- NEGATIVE FOR HELICOBACTOR-LIKE ORGANISMS.
- NEGATIVE FOR INTESTINAL METAPLASIA.
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY.

See also

References

  1. Fyfe, B.; Poppiti, RJ.; Lubin, J.; Robinson, MJ. (Aug 1993). "Gastric syphilis. Primary diagnosis by gastric biopsy: report of four cases.". Arch Pathol Lab Med 117 (8): 820-3. PMID 8343046.
  2. Lv, SX.; Gan, JH.; Ma, XG.; Wang, CC.; Chen, HM.; Luo, EP.; Huang, XP.; Wu, SH. et al. (May 2012). "Biopsy from the base and edge of gastric ulcer healing or complete healing may lead to detection of gastric cancer earlier: an 8 years endoscopic follow-up study.". Hepatogastroenterology 59 (115): 947-50. doi:10.5754/hge10692. PMID 22469743.