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Difference between revisions of "Reactive gastropathy"
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| Caption = Reactive gastropathy. [[H&E stain]]. | | Caption = Reactive gastropathy. [[H&E stain]]. | ||
| Micro = | | Micro = foveolar hyperplasia - esp. tortuosity of glands in the "neck" region (S shaped glands), smooth muscle hyperplasia, scant inflammatory cells, +/-edema, +/-erosions | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = | | LMDDx = | ||
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'''Reactive gastropathy''', abbreviated '''RG''', a relatively common pathology of the [[stomach]]. It is also known as ''chemical gastropathy'',<ref name=pmid16939055>{{Cite journal | last1 = Genta | first1 = RM. | title = Differential diagnosis of reactive gastropathy. | journal = Semin Diagn Pathol | volume = 22 | issue = 4 | pages = 273-83 | month = Nov | year = 2005 | doi = | PMID = 16939055 }}</ref> and incorrectly referred to as ''chemical gastritis'' (see below). | '''Reactive gastropathy''', abbreviated '''RG''', a relatively common pathology of the [[stomach]]. It is also known as ''chemical gastropathy'',<ref name=pmid16939055>{{Cite journal | last1 = Genta | first1 = RM. | title = Differential diagnosis of reactive gastropathy. | journal = Semin Diagn Pathol | volume = 22 | issue = 4 | pages = 273-83 | month = Nov | year = 2005 | doi = | PMID = 16939055 }}</ref> and incorrectly referred to as ''chemical gastritis'' (see below). | ||
==General== | |||
*May be seen in the context of a previous resection/surgical reconstruction, e.g. Billroth II. | *May be seen in the context of a previous resection/surgical reconstruction, e.g. Billroth II. | ||
===Epidemiology=== | |||
General assocations: | General assocations: | ||
*Increases with age.<ref name=pmid22928604>{{Cite journal | last1 = Maguilnik | first1 = I. | last2 = Neumann | first2 = WL. | last3 = Sonnenberg | first3 = A. | last4 = Genta | first4 = RM. | title = Reactive gastropathy is associated with inflammatory conditions throughout the gastrointestinal tract. | journal = Aliment Pharmacol Ther | volume = | issue = | pages = | month = Aug | year = 2012 | doi = 10.1111/apt.12031 | PMID = 22928604 }}</ref> | *Increases with age.<ref name=pmid22928604>{{Cite journal | last1 = Maguilnik | first1 = I. | last2 = Neumann | first2 = WL. | last3 = Sonnenberg | first3 = A. | last4 = Genta | first4 = RM. | title = Reactive gastropathy is associated with inflammatory conditions throughout the gastrointestinal tract. | journal = Aliment Pharmacol Ther | volume = | issue = | pages = | month = Aug | year = 2012 | doi = 10.1111/apt.12031 | PMID = 22928604 }}</ref> | ||
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===Relation to gastritis=== | |||
*May mimic a (true) gastritis symptomatically and visually in an endoscopic examination. | *May mimic a (true) gastritis symptomatically and visually in an endoscopic examination. | ||
*"Chemical gastritis" is misnomer. Etymologically, the ''-itis'' in ''gastritis'', implies an inflammatory process. Chemical gastropathy is not (predominantly) an inflammatory process. | *"Chemical gastritis" is misnomer. Etymologically, the ''-itis'' in ''gastritis'', implies an inflammatory process. Chemical gastropathy is not (predominantly) an inflammatory process. | ||
**This type of confusion is not uncommon. [[Steatohepatitis]] is another example of this; it is not a process with significant inflammation yet, confusingly, carries the ''-itis'' ending. | **This type of confusion is not uncommon. [[Steatohepatitis]] is another example of this; it is not a process with significant inflammation yet, confusingly, carries the ''-itis'' ending. | ||
==Gross/endoscopic== | |||
Features:<ref>{{Ref GLP|69}}</ref> | Features:<ref>{{Ref GLP|69}}</ref> | ||
*Antral erythema +/- erosions. | *Antral erythema +/- erosions. | ||
*+/-Bile. | *+/-Bile. | ||
==Microscopic== | |||
Features - triad:<ref>El-Zimaity. 18 October 2010.</ref><ref name=pmid16939055/> | Features - triad:<ref>El-Zimaity. 18 October 2010.</ref><ref name=pmid16939055/> | ||
#Foveolar hyperplasia. | #Foveolar hyperplasia. | ||
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*[[Hyperplastic polyp of the stomach]].<ref name=Ref_GLP69>{{Ref GLP|69}}</ref> | *[[Hyperplastic polyp of the stomach]].<ref name=Ref_GLP69>{{Ref GLP|69}}</ref> | ||
===Images=== | |||
<gallery> | <gallery> | ||
Image: Reactive_gastropathy_-_low_mag.jpg | RG - low mag. (WC/Nephron) | Image: Reactive_gastropathy_-_low_mag.jpg | RG - low mag. (WC/Nephron) | ||
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</gallery> | </gallery> | ||
==Sign out== | |||
<pre> | <pre> | ||
STOMACH, BIOPSY: | STOMACH, BIOPSY: | ||
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</pre> | </pre> | ||
===Not well-developed=== | |||
<pre> | <pre> | ||
STOMACH, BIOPSY: | STOMACH, BIOPSY: | ||
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- NEGATIVE FOR HELICOBACTER-LIKE ORGANISMS. | - NEGATIVE FOR HELICOBACTER-LIKE ORGANISMS. | ||
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | - NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | ||
COMMENT: | COMMENT: | ||