Gastric ulcer

From Libre Pathology
(Redirected from Stomach ulcer)
Jump to navigation Jump to search

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 biopsy the ulcer edge, as the dictum is: the cancer is there; this dictum may not be true.[2]
  • Ulcer with clean base refers to nothing "in" the ulcer (depression); these may be benign or malignant.[3]
    • The term is within a popular classification of upper GI bleeding.[4]

Images

Microscopic

Features:

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

Images

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

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.
  3. Gielisse EA, Kuyvenhoven JP (October 2015). "Follow-up endoscopy for benign-appearing gastric ulcers has no additive value in detecting malignancy: It is time to individualise surveillance endoscopy". Gastric Cancer 18 (4): 803–9. doi:10.1007/s10120-014-0433-4. PMID 25312052.
  4. URL: https://www.endoscopy-campus.com/en/classifications/forrest-classification/. Accessed: 2022 January 11.