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Difference between revisions of "Stomach"
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=Miscellaneous= | =Miscellaneous= | ||
This is a grab bag of stuff seen in the stomach. Some of it is quite rare. | |||
==Gastric antral vascular ectasia== | ==Gastric antral vascular ectasia== | ||
===General=== | ===General=== | ||
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*Amyloidosis. | *Amyloidosis. | ||
*Collagenous gastritis. | *Collagenous gastritis. | ||
==Gastric atrophy== | |||
===General=== | |||
*Has a wide differential diagnosis. | |||
===Microscopic=== | |||
Can take three general forms: | |||
#Intestinal metaplasia - see ''intestinal metaplasia'' section. | |||
#Pseudopyloric metaplasia; gastric body looks like gastric antrum. | |||
#*Characterized by ''foveolar hyperplasia''. | |||
#Cell loss without replacement. | |||
#*Clue is deep inflammation in the body. | |||
==Lymphocytic gastritis== | |||
===General=== | |||
DDx: | |||
*Celiac disease. | |||
**Check [[duodenum]]. | |||
*H. pylori. | |||
*HIV/AIDS. | |||
===Microscopic=== | |||
Features:<ref>El-Zimaity. 18 October 2010.</ref> | |||
*25 lymphocytes / 100 epithelial cells. | |||
==Pernicious anemia== | |||
===General=== | |||
*Gastric atrophy. | |||
*Loss of parietal cells. | |||
*Intrinsic factor antibodies present in serum. | |||
**Intrinsic factor -- absorbs vitamin B12. | |||
===Microscopic=== | |||
Features: | |||
*Corpus predominant inflammation. | |||
*Increased G cells in the antrum. | |||
***Increased gastrin level to try and stimulate (missing) parietal cells. | |||
*See ''gastric atrophy'' section. | |||
==Collagenous gastritis== | |||
===General=== | |||
*Very rare. | |||
*Associated ''[[collagenous colitis]]''. | |||
===Microscopic=== | |||
Features: | |||
*Eosinophilic material (collagen) expands lamina propria. | |||
**Band of collagen must be ~thick as RBC diameter. | |||
***Proven by trichrome stain that highlights collagen. | |||
==Granulomatous gastritis== | |||
*Usual DDx of granulomatous disease (see ''[[Basics]]'' article): | |||
**DNF AAII: | |||
***Drugs, Neoplasms, Foreign body, Autoimmune, Allergic, Infectious, Idiopathic. | |||
Important ones: | |||
*Autoimmune - [[Crohn's disease]]. | |||
*Infectious - Tuberculosis. | |||
*Idiopathic - Sarcoidosis. | |||
==Miscellaneous== | |||
*DDx of Plasmacytosis: | |||
**[[Plasma cell dyscrasia]]. | |||
**Syphilis. | |||
=Gastric polyps= | =Gastric polyps= | ||