Small bowel (small intestine) - Heterotopic gastric mucosa

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Small bowel (small intestine)

Congenital anomalies

Heterotopic gastric mucosa

Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 13 December 2012, last major update August 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Mature gastric tissue in location where normally not found (i.e. small bowel)
● Discrete small nodules or sessile polyps, usually in duodenum (first and second part)
● May cause obstruction, diarrhea, ulceration, bleeding, perforation, intussusception, pain (Pediatr Dev Pathol 2000;3:277)
● Presence in duodenum is associated with H. pylori infection and is probably not congenital (Hum Pathol 2003;34:156)

Case reports
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● 50 year old man with duodenal polyp (Case of the Week #124)
● 52 year old woman with jejunal mass (Arch Pathol Lab Med 2003;127:506)
● 67 year old woman with gastric type adenoma (Virchows Arch 1999;435:452)

Gross images
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Case of the Week #124

Figure 1

Micro description
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● Mature gastric tissue, usually fundic type mucosa with chief and parietal cells, lined by foveolar epithelium, with a full mucosal thickness, forming a mucosal island
● Divided into two subtypes, one lined by foveolar epithelium only and another foveolar epithelium along with fundic glands
● The former may be congenital or acquired (metaplasia) and latter is only congenital (Int J Clin Exp Pathol 2012;5:46)

Micro images
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Case of the Week #124

Various images

Differential diagnosis
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● Gastric metaplasia: associated with chronic inflammation, duodenitis and H. pylori, only occupies part of mucosal thickness, typically no gross findings, no parietal cells (Braz J Med Biol Res 2007;40:897, Dig Liver Dis 2002;34:16)
● Peptic ulcer disease: no goblet cells

End of Small bowel (small intestine) > Congenital anomalies > Heterotopic gastric mucosa

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