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Stomach

Gastritis

Features to report


Reviewers: Elliot Weisenberg, M.D. (see Reviewers page)
Revised: 31 July 2012, last major update July 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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Sydney system
Biopsies:
● Recommended to take 5 biopsy specimens, 2 from antrum (both at 2 to 3 cm from the pylorus, 1 from lesser and 1 from greater curvature), 2 from corpus (both at 8 cm from the cardia, from lesser and greater curvature), 1 from the incisura angularis
● All samples should be identified and studied separately
● 5 biopsies appears to be adequate, although site is often misidentified
● The Sydney system guidelines technically should only be applied when all 5 biopsy sites are submitted for examination (Hum Pathol 003;34:28)
● Low concordance rate between pathologists improves after joint review of cases (Hum Pathol 1999;30:1431)
● Proposed new system for staging and grading (Hum Pathol 2005;36:228)

Report:
● Location of gastritis (antrum, fundus/body, cardia, diffuse)
● Type of gastritis: active, chronic or other (lymphocytic, granulomatous, eosinophilic, etc.)
● Grade the presence of Helicobacter pylori, chronic inflammation, active inflammation, glandular atrophy, intestinal metaplasia
● Report (ungraded) granulomas, eosinophils, intraepithelial lymphocytes
● Special stain to detect H. pylori is recommended when inflammation is present

Alternative reporting:
● Antral predominant, corpus predominant or pangastritis
● Focal or diffuse
● Superficial or full thickness
● Atrophy: present or absent
● Metaplasia: present or absent
● Inflammation: active, chronic or both
H. pylori present or absent

End of Stomach > Gastritis > Features to report


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