Gastric ulcer

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:

• Gastric carcinoma.
• Peptic ulcer disease.
  • Helicobacter gastritis.
• Syphilis.
• Other causes.

Gross

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

Notes:

• The classical teaching is to biopsy the ulcer edge, as the dictum is: the cancer is there; this dictum may not be true.
• Ulcer with clean base refers to nothing "in" the ulcer (depression); these may be benign or malignant.
  • The term is within a popular classification of upper GI bleeding.

Images

• 

  Malignant ulcer of the stomach. (WC)

Microscopic

Features:

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

Images

• 

  SU - low mag. (WC)

• 

  SU - intermed. mag. (WC)

Sign out

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

• Stomach.
• Helicobacter gastritis.
• Gastric adenocarcinoma.
• Cameron lesion.