Stomach
General
Normal histology


Topic Completed: 1 July 2012

Revised: 22 March 2019

Copyright: 2003-2019, PathologyOutlines.com, Inc.

PubMed Search: normal histology stomach

Elliot Weisenberg, M.D.
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Cite this page: Weisenberg E. Normal histology. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/stomachnormalhistology.html. Accessed July 21st, 2019.
Definition / general
  • Layers:
    • Mucosa
    • Submucosa (with Meissner plexus)
    • Muscularis propria (outer longitudinal layer, Auerbach / myenteric plexus, inner circular layer, innermost oblique layer)
    • Serosa

  • Mucosal protection against autodigestion:
    • Mucus secretion: mucus is relatively impermeable to H+; also fluid with acid or pepsin exits gastric glands as jets and penetrates surface mucus layer without contacting surface epithelial cells
    • Bicarbonate secretion creates pH neutral microenvironment adjacent to cell surface
    • Intercellular tight junctions prevent back diffusion of H+; disruptions are quickly repaired
    • Rich blood flow supplies bicarbonate and nutrients and removes acid
    • Muscularis mucosa limits injury; if intact, repair occurs in hours / days vs. weeks if not intact
Mucosal components
  • Gastric mucosa has two compartments:
    1. Superficial foveolar compartment, relatively uniform throughout, consists of surface epithelial / foveolar cells lining the entire mucosal surface and pits
    2. Deep glandular compartment, varying composition and thickness in different regions containing gastric glands

  • The gastric mucosa is very metabolically active
  • The entire mucosa is replaced every 2 to 8 days (varies by source)
  • Mucous neck cells at the base of foveola are progenitors of surface epithelium and gastric glands, mitotically active, site of gastric carcinogenesis
  • Ratio of foveola to gland volume differs by region: cardia / antrum: 50 / 50; fundus: 25 / 75
Cell types
Cardia
Fundus
  • Also known as oxyntic mucosa
  • Straight glands composed of tightly packed chief cells, parietal cells, endocrine cells, mucus cells
  • Higher ratio of glands to foveola than antrum
  • Region of fundic mucosa shrinks with age (termed pyloric metaplasia)

Antrum
  • Branching mucus glands, cytoplasm may be bubbly, vacuolated, granular or glassy
  • Sometimes ciliated in Japanese patients (Jpn J Cancer Res 1986;77:282, case report in American patient at Am J Surg Pathol 1988;12:786)
  • May contain small aggregates of lymphocytes without germinal centers

Parietal cells
  • Primarily in fundus / body
  • Eosinophilic due to abundant mitochondria, produce acid via H+ / K+ ATPase pump
  • Also secrete intrinsic factor which binds luminal vitamin B12
  • Stimulated by vagus nerve, binding of gastrin receptor by gastrin from antral cells, binding of H2 receptor by histamine from enterochromaffin-like cells
  • Histamine is the most important pathway

Chief cells
  • Fundus / body
  • Basophilic cytoplasm due to abundant rough endoplasmic reticulum
  • Release pepsinogen I and II, which are activated by low luminal pH to pepsin

Endocrine cells
  • Scattered in fundus / body (produce histamine, are enterochromaffin-like), more prominent in antral glands
  • Produce gastrin (G cells), serotonin (enterochromaffin cells), somatostatin (D cells)
  • Often have clear cytoplasm

Enterochromaffin-like (ECL) cells
  • Nonpeptide secreting endocrine cell of gastric fundus / body mucosa
  • Represent 30% of endocrine cells
  • Release histamine in response to gastrin produced by G cells
  • Long term gastrin stimulation causes ECL hyperplasia

Mucous cells
  • Produce neutral (PAS+) mucin, usually not acidic mucins
  • Lightly eosinophilic or clear cytoplasm and bubbly

Ganglion cells
  • Associated with Meissner and Auerbach plexuses
  • Negative stains: CDX2 (except in areas of intestinal metaplasia)
Microscopic (histologic) images

Contributed by Dr. Grigory Demyashkin, I. M. Sechenov First Moscow State Medical University (Russia) - 6 - 8 week embryo

Upper left: small intestine;
bottom left: esophagus;
center: stomach;
top right: pancreas; right: liver

Left: small intestine; bottom: stomach;
center: gonad & kidney primary (mesonephros);
right: symphysis



Images hosted on other servers:

Cardia: area adjacent to squamocolumnar junction, cardiac mucosa

Fundus: fundic mucosa


Antrum: antral / pyloric mucosa

Parietal cells

Ganglion cells: neural
bundle with ganglion
cells should not be mistaken
for infiltrating tumor cells

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