Stomach and Duodenum

Abstract

The stomach and the duodenum are covered together as they are commonly submitted in the same set of biopsies, and the pathology may be continuous. Survey the glandular epithelium at low power. Note what kind of mucosa you have and whether it correlates with what the endoscopist thought. Assess the color of the biopsy specimen. A healthy stomach is a fairly pale pink, overall. If your general impression is blue, this probably indicates inflammation in the stroma, such as in gastritis. If your impression is that of a pink stroma with unusually dark and distinct glands, you may be looking at chemical gastritis. Look for intestinal metaplasia, or goblet cells, a marker of chronic irritation in the stomach. Goblet cells are usually visible from low power, especially on a PAS/AB stain (as indigo-blue, bulbous cells). Look for areas of exudate, neutrophils, debris, and ragged-looking glands that indicate an erosion or ulcer.