Chronic gastritis

1.    Which part of the stomach is the histologic section taken from?

       The pyloric antrum (deep pits and short branched glands)

2.    What pathological process does it illustrate?

        Chronic inflammation

3.    Name the characteristic cells involved in this process and state their functions.

       Macrophages

       Func: release chemical mediators to control the extent of tissue injury and fibrosis.

       Lymphocytes

       Func: stimulates release of monocytes and macrophages.

       Mast cells

                   Func: elaborates cytokines which augments leukocyte infiltration at site of response

       Eosinophils

       Func: contains major basic protein which is toxic to parasites.  Also causes lysis of mammalian epithelial cells

4.    Where are the cells located?

        In the circulation until recruited

        In the circulation until recruited

        In  connective tissues

        In the circulation until recruited

5.    Name some aetiologic associations.  Is the aetiology obvious in this case?

        Helicobacter pylori, alcohol, duodenal reflux, autoimmune mechanism.

6.    What adaptional changes may be seen in the cells of the gastric mucosa in the setting of chronic gastritis?

       Glandular atrophy of mucous glands and other specialised glands.  Mild         hypertrophy of undamaged cells.  Metaplasia of small intestinal glands replacing that in the stomach.  Usually inflammation is also evident and there are both aggregated and solitary lymphoid tissues.

7.    What functional disturbances/complications can ensue in the long term?

        Increase in the risk of gastric cancer, pernicious anaemia (vit B12 def due to            Lack of intrinsic factor) and also possibly cardiac failure from the anaemia thus   developed.

        Gastric lymphoma.

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Copyright � Joseph Ong 2003