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Benign Diseases of the Stomach

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Surgical Pathology of the Gastrointestinal System

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Abstract

Inflammatory diseases of the stomach cover a broad spectrum of diseases ranging from erosions and hemorrhagic gastritis to the potential precursor lesions of gastric neoplasia. Among these, the predominant focus has been laid on the different forms of Helicobacter pylori (H. pylori)-related gastritis throughout the globe and especially in the developing world. In addition, this chapter also intends to provide an overview of certain H. pylori-negative gastritis quite frequently encountered in routine luminal gastrointestinal pathology practice, like eosinophilic gastritis, lymphocytic (collagenous) gastritis, and granulomatous gastritis, along with few polypoid inflammatory lesions.

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References

  1. Chamberlain CE. Acute haemorrhagic gastritis. Gastroenterol Clin N Am. 1993;22(4):843–73.

    CAS  Google Scholar 

  2. Kanchan T, Geriani D, Savithry KS. Curling’s ulcer - have these stress ulcers gone extinct? Burns. 2015;41(1):198–9.

    PubMed  Google Scholar 

  3. MacMath TL. Alcohol and gastrointestinal bleeding. Emerg Med Clin North Am. 1990;8(4):859–72.

    CAS  PubMed  Google Scholar 

  4. Dixon MF, Genta RM, Yardley JH, Correa P. Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol. 1996;20(10):1161–81.

    CAS  PubMed  Google Scholar 

  5. Maguilnik I, Neumann WL, Sonnenberg A, Genta RM. Reactive gastropathy is associated with inflammatory conditions throughout the gastrointestinal tract. Aliment Pharmacol Ther. 2012;36(8):736–43.

    CAS  PubMed  Google Scholar 

  6. Sugano K, Tack J, Kuipers EJ, et al. Kyoto global consensus report on Helicobacter pylori gastritis. Gut. 2015;64:1353–67.

    PubMed  Google Scholar 

  7. Rugge M, Meggio A, Pennelli G, et al. Gastritis staging in clinical practice: the OLGA staging system. Gut. 2007;56:631–6.

    PubMed  Google Scholar 

  8. Rugge M, de Boni M, Pennelli G, et al. Gastritis OLGA-staging and gastric cancer risk: a twelve-year clinico-pathological follow-up study. Aliment Pharmacol Ther. 2010;31:1104–11.

    CAS  PubMed  Google Scholar 

  9. Capelle LG, de Vries AC, Haringsma J, et al. The staging of gastritis with the OLGA system by using intestinal metaplasia as an accurate alternative for atrophic gastritis. Gastrointest Endosc. 2010;71:1150–8.

    PubMed  Google Scholar 

  10. Warren JR, Marshall B. Unidentified curved bacilli on gastric epithelium in active chronic gastritis. Lancet. 1983;1:1273–5.

    CAS  PubMed  Google Scholar 

  11. Wang F, Meng W, Wang B, Qiao L. Helicobacter pylori-induced gastric inflammation and gastric cancer. Cancer Lett. 2014;345(2):196–202.

    CAS  PubMed  Google Scholar 

  12. Ansari S, Yamaoka Y. Helicobacter pylori virulence factors exploiting gastric colonization and its pathogenicity. Toxins (Basel). 2019;11(11):677.

    CAS  Google Scholar 

  13. Stolte M, Meining A. The updated Sydney system: classification and grading of gastritis as the basis of diagnosis and treatment. Can J Gastroenterol. 2001;15(9):591–8.

    CAS  PubMed  Google Scholar 

  14. Boylan KE, Patrey S, McMullen PD, Tesic V, Weber CR, Hart J, Setia N. Objective visual analog scale for biopsy DIAGNOSIS of Helicobacter pylori infection in clinical practice. Am J Surg Pathol. 2021;45(5):672–9.

    PubMed  Google Scholar 

  15. Fock KM, Ang TL. Epidemiology of Helicobacter pylori infection and gastric cancer in Asia. J Gastroenterol Hepatol. 2010;25(3):479–86.

    CAS  PubMed  Google Scholar 

  16. Ghoshal UC, Chaturvedi R, Correa P. The enigma of Helicobacter pylori infection and gastric cancer. Indian J Gastroenterol. 2010;29(3):95–100.

    PubMed  PubMed Central  Google Scholar 

  17. Whitmire JM, Merrell DS. Helicobacter pylori genetic polymorphisms in gastric disease development. Adv Exp Med Biol. 2019;1149:173–94.

    CAS  PubMed  Google Scholar 

  18. Rudnicka K, Backert S, Chmiela M. Genetic polymorphisms in inflammatory and other regulators in gastric cancer: risks and clinical consequences. Curr Top Microbiol Immunol. 2019;421:53–76.

    CAS  PubMed  Google Scholar 

  19. El-Zimaity H, Choi WT, Lauwers GY, Riddell R. The differential diagnosis of Helicobacter pylori negative gastritis. Virchows Arch. 2018;473(5):533–50.

    PubMed  Google Scholar 

  20. Kishikawa H, Ojiro K, Nakamura K, Katayama T, Arahata K, Takarabe S, Miura S, Kanai T, Nishida J. Previous Helicobacter pylori infection-induced atrophic gastritis: a distinct disease entity in an understudied population without a history of eradication. Helicobacter. 2020;25(1):e12669.

    CAS  PubMed  Google Scholar 

  21. Shichijo S, Hirata Y, Niikura R, Hayakawa Y, Yamada A, Koike K. Association between gastric cancer and the Kyoto classification of gastritis. J Gastroenterol Hepatol. 2017;32:1581–6.

    PubMed  Google Scholar 

  22. Cockburn AN, Morgan CJ, Genta RM. Neuroendocrine proliferations of the stomach: a pragmatic approach for the perplexed pathologist. Adv Anat Pathol. 2013;20(3):148–57.

    CAS  PubMed  Google Scholar 

  23. Grin A, Kim YI, Mustard R, Streutker CJ, Riddell RH. Duodenal gastrinoma withmultiple gastric neuroendocrine tumors secondary to chronic Helicobacter pylori gastritis. Am J Surg Pathol. 2012;36:935–40.

    PubMed  Google Scholar 

  24. De Re V, Repetto O, Zanussi S, Casarotto M, Caggiari L, Canzonieri V, Cannizzaro R. Protein signature characterizing Helicobacter pylori strains of patients with autoimmune atrophic gastritis, duodenal ulcer and gastric cancer. Infect Agent Cancer. 2017;12:22.

    PubMed  PubMed Central  Google Scholar 

  25. Yamaguchi E, Iwasa T, Ihara E, Tomita Y, Aso A, Oki E, Nakano K, Hirahashi M, Nakamura K. Gastric neuroendocrine tumor with hypergastrinemia following type B chronic atrophic gastritis: a case report. Nihon Shokakibyo Gakkai Zasshi. 2017;114:248–55.

    PubMed  Google Scholar 

  26. Vorobjova T, Maaroos HI, Uibo R. Immune response to Helicobacter pylori and its association with the dynamics of chronic gastritis in the antrum and corpus. APMIS. 2008;116:465–76.

    CAS  PubMed  Google Scholar 

  27. Antico A, Tampoia M, Villalta D, Tonutti E, Tozzoli R, Bizzaro N. Clinical usefulness of the serological gastric biopsy for the diagnosis of chronic autoimmune gastritis. Clin Dev Immunol. 2012;2012:520970.

    PubMed  PubMed Central  Google Scholar 

  28. Pittman ME, Voltaggio L, Bhaijee F, Robertson SA, Montgomery EA. Autoimmune metaplastic atrophic gastritis: recognizing precursor lesions for appropriate patient evaluation. Am J Surg Pathol. 2015;39:1611–20.

    PubMed  Google Scholar 

  29. Rodriguez-Castro KI, Franceschi M, Miraglia C, Russo M, Nouvenne A, Leandro G, Meschi T, De’Angelis GL, Di Mario F. Autoimmune diseases in autoimmune atrophic gastritis. Acta Biomed. 2018;89(8-S):100–3.

    CAS  PubMed  Google Scholar 

  30. Massironi S, Zilli A, Elvevi A, Invernizzi P. The changing face of chronic autoimmune atrophic gastritis: an updated comprehensive perspective. Autoimmun Rev. 2019;18(3):215–22.

    PubMed  Google Scholar 

  31. Kawanaka M, Tanikawa T, Kamada T, Ishii K, Urata N, Nakamura J, Nishino K, Suehiro M, Sasai T, Manabe N, Monobe Y, Kawamoto H, Haruma K. High prevalence of autoimmune gastritis in patients with nonalcoholic steatohepatitis. Intern Med. 2019;58(20):2907–13.

    CAS  PubMed  PubMed Central  Google Scholar 

  32. Bektas M, Sarac N, Cetinkaya H, Toruner M, Erdemli E, Keskin O, Soykan I, Oktay EI, Korkut E, Ustun Y, Bahar K. Effects of Helicobacter pylori infection and long-term proton pump inhibitor use on enterochromaffin-like cells. Ann Gastroenterol. 2012;25:123–7.

    PubMed  PubMed Central  Google Scholar 

  33. Solcia E, Fiocca R, Villani L, et al. Morphology and pathogenesis of endocrine hyperplasias, precarcinoid lesions, and carcinoids arising in chronic atrophic gastritis. Scand J Gastroenterol Suppl. 1991;180:146–59.

    CAS  PubMed  Google Scholar 

  34. Solcia E, Fiocca R, Rindi G, et al. Endocrine tumors of the small and large intestine. Pathol Res Pract. 1995;191:366–72.

    CAS  PubMed  Google Scholar 

  35. Maeng L, Lee A, Choi K, Kang CS, Kim KM. Granulomatous gastritis: a clinicopathologic analysis of 18 biopsy cases. Am J Surg Pathol. 2004;28(7):941–5.

    PubMed  Google Scholar 

  36. Laube R, Liu K, Schifter M, Yang JL, Suen MK, Leong RW. Oral and upper gastrointestinal Crohn’s disease. J Gastroenterol Hepatol. 2018;33(2):355–64.

    PubMed  Google Scholar 

  37. Srivastava A, Lauwers GY. Pathology of non-infective gastritis. Histopathology. 2007;50:15–29.

    CAS  PubMed  Google Scholar 

  38. Polydorides AD. Pathology and differential diagnosis of chronic, noninfectious gastritis. Semin Diagn Pathol. 2014;31:114–23.

    PubMed  Google Scholar 

  39. Dulai PS, Rothstein RI. Disseminated sarcoidosis presenting as granulomatous gastritis: a clinical review of the gastrointestinal and hepatic manifestations of sarcoidosis. J Clin Gastroenterol. 2012;46(5):367–74.

    PubMed  Google Scholar 

  40. Brito-Zerón P, Bari K, Baughman RP, Ramos-Casals M. Sarcoidosis involving the gastrointestinal tract: diagnostic and therapeutic management. Am J Gastroenterol. 2019;114(8):1238–47.

    PubMed  Google Scholar 

  41. Shapiro JL, Goldblum JR, Petras RE. A clinicopathologic study of 42 patients with granulomatous gastritis. Is there really an “idiopathic” granulomatous gastritis? Am J Surg Pathol. 1996;20:462–70.

    CAS  PubMed  Google Scholar 

  42. Spergel JM, Book WM, Mays E, Song L, Shah SS, Talley NJ, Bonis PA. Variation in prevalence, diagnostic criteria, and initial management options for eosinophilic gastrointestinal diseases in the United States. J Pediatr Gastroenterol Nutr. 2011;52:300–6.

    PubMed  PubMed Central  Google Scholar 

  43. Gonsalves N. Eosinophilic gastrointestinal disorders. Clin Rev Allergy Immunol. 2019;57(2):272–85.

    PubMed  Google Scholar 

  44. Pesek RD, Reed CC, Muir AB, Fulkerson PC, Menard-Katcher C, Falk GW, Kuhl J, Martin EK, Magier AZ, Ahmed F, Demarshall M, Gupta A, Gross J, Ashorobi T, Carpenter CL, Krischer JP, Gonsalves N, Spergel JM, Gupta SK, Furuta GT, Rothenberg ME, Dellon ES, Consortium of Eosinophilic Gastrointestinal Disease Researchers (CEGIR). Increasing rates of diagnosis, substantial co-occurrence, and variable treatment patterns of eosinophilic gastritis, gastroenteritis, and colitis based on 10-year data across a multicenter consortium. Am J Gastroenterol. 2019;114(6):984–94.

    PubMed  PubMed Central  Google Scholar 

  45. Guajardo JR, Plotnick LM, Fende JM, et al. Eosinophil-associated gastrointestinal disorders: a world-wide-web based registry. J Pediatr. 2002;141(4):576–81.

    PubMed  Google Scholar 

  46. Khan S, Orenstein SR. Eosinophilic gastroenteritis. Gastroenterol Clin N Am. 2008;37(2):333–48.

    Google Scholar 

  47. Caldwell JM, Collins MH, Stucke EM, et al. Histologic eosinophilic gastritis is a systemic disorderassociated with blood and extragastric eosinophilia, TH2 immunity, and a unique gastric transcriptome. J Allergy Clin Immunol. 2014;134:1114–24.

    CAS  PubMed  PubMed Central  Google Scholar 

  48. Shoda T, Wen T, Caldwell JM, Collins MH, Besse JA, Osswald GA, Abonia JP, Arva NC, Atkins D, Capocelli KE, Dellon ES, Falk GW, Gonsalves N, Gupta SK, Hirano I, Mukkada VA, Putnam PE, Sheridan RM, Rudman Spergel AK, Spergel JM, Wechsler JB, Yang GY, Aceves SS, Furuta GT, Rothenberg ME, Consortium of Eosinophilic Gastrointestinal Disease Researchers (CEGIR). Molecular, endoscopic, histologic, and circulating biomarker-based diagnosis of eosinophilic gastritis: multi-site study. J Allergy Clin Immunol. 2020;145(1):255–69.

    CAS  PubMed  Google Scholar 

  49. Zhang M, Li Y. Eosinophilic gastroenteritis: a state-of-the-art review. J Gastroenterol Hepatol. 2017;32(1):64–72.

    PubMed  Google Scholar 

  50. Lwin T, Melton SD, Genta RM. Eosinophilic gastritis: histopathological characterization and quantification of the normal gastric eosinophil content. Mod Pathol. 2011;24:556–63.

    PubMed  Google Scholar 

  51. Cianferoni A, Spergel JM. Eosinophilic esophagitis and gastroenteritis. Curr Allergy Asthma Rep. 2015;15:58.

    PubMed  Google Scholar 

  52. Rothenberg ME. Eosinophilic gastrointestinal disorders (EGID). J Allergy Clin Immunol. 2004;113:11–28; quiz 29

    CAS  PubMed  Google Scholar 

  53. Klein NC, Hargrove RL, Sleisenger MH, et al. Eosinophilic gastroenteritis. Medicine (Baltimore). 1970;49(4):299–319.

    CAS  Google Scholar 

  54. Uppal V, Kreiger P, Kutsch E. Eosinophilic Gastroenteritis and Colitis: a Comprehensive Review. Clinic Rev Allerg Immunol. 2016;50(2):175–88. https://doi.org/10.1007/s12016-015-8489-4.

    Article  Google Scholar 

  55. Walker MM, Potter M, Talley NJ. Eosinophilic gastroenteritis and other eosinophilic gut diseases distal to the oesophagus. Lancet Gastroenterol Hepatol. 2018;3(4):271–80.

    PubMed  Google Scholar 

  56. Yip RHL, Lee LH, Lee LH, Schaeffer DF, Horst BA, Yang HM. Topography, morphology, and etiology of lymphocytic gastritis: a single institution experience. Virchows Arch. 2020;476(4):551–9.

    PubMed  Google Scholar 

  57. Yip RHL, Lee LH, Lee LH, Schaeffer DF, Horst BA, Yang HM. Topography, morphology, and etiology of lymphocytic gastritis: a focus on celiac disease. Virchows Arch. 2020;477(1):167.

    PubMed  Google Scholar 

  58. Huh WJ, Coffey RJ, Washington MK. Ménétrier’s disease: its mimickers and pathogenesis. J Pathol Transl Med. 2016;50(1):10–6.

    PubMed  Google Scholar 

  59. Bayerdörffer E, Ritter MM, Hatz R, Brooks W, Stolte M. Ménétrier’s disease and Helicobacter pylori. N Engl J Med. 1993;329(1):60.

    PubMed  Google Scholar 

  60. Garg H, Gupta S, Anand AC, Broor SL. Portal hypertensive gastropathy and gastric antral vascular ectasia. Indian J Gastroenterol. 2015;34(5):351–8.

    PubMed  Google Scholar 

  61. Kar P, Mitra S, Resnick JM, Torbey CF. Gastric antral vascular ectasia: case report and review of the literature. Clin Med Res. 2013;11(2):80–5.

    PubMed  Google Scholar 

  62. Rockey DC. An update: portal hypertensive gastropathy and colopathy. Clin Liver Dis. 2019;23(4):643–58.

    PubMed  PubMed Central  Google Scholar 

  63. Samuel R, Bilal M, Tayyem O, Guturu P. Evaluation and management of non-variceal upper gastrointestinal bleeding. Dis Mon. 2018;64(7):333–43.

    PubMed  Google Scholar 

  64. Tanaka T, Sugaya T, Tominaga K, Kanazawa M, Suzuki T, Ishikawa M, Yamamiya A, Arisaka T, Majima Y, Iijima M, Goda K, Irisawa A. Gastric Dieulafoy’s lesion with subepithelial lesion-like morphology. Clin J Gastroenterol. 2021;14(1):71–5.

    PubMed  Google Scholar 

  65. Sonnenberg A, Genta RM. Prevalence of benign gastric polyps in a large pathology database. Dig Liver Dis. 2015;47(2):164–9.

    PubMed  Google Scholar 

  66. Park DY, Lauwers GY. Gastric polyps: classification and management. Arch Pathol Lab Med. 2008;132(4):633–40.

    PubMed  Google Scholar 

  67. Vos S, van der Post RS, Brosens LAA. Gastric epithelial polyps: when to ponder, when to panic. Surg Pathol Clin. 2020;13(3):431–52.

    PubMed  Google Scholar 

  68. Jain R, Chetty R. Gastric hyperplastic polyps: a review. Dig Dis Sci. 2009;54(9):1839–46.

    PubMed  Google Scholar 

  69. Hizawa K, Fuchigami T, Iida M, Aoyagi K, Iwashita A, Daimaru Y, Fujishima M. Possible neoplastic transformation within gastric hyperplastic polyp. Surg Endosc. 1995;9(6):714–8.

    CAS  PubMed  Google Scholar 

  70. Fukuda M, Ishigaki H, Sugimoto M, Mukaisho KI, Matsubara A, Ishida H, Moritani S, Itoh Y, Sugihara H, Andoh A, Ogasawara K, Murakami K, Kushima R. Histological analysis of fundic gland polyps secondary to PPI therapy. Histopathology. 2019;75(4):537–45.

    PubMed  Google Scholar 

  71. Choudhry U, Boyce HW Jr, Coppola D. Proton pump inhibitor-associated gastric polyps: a retrospective analysis of their frequency, and endoscopic, histologic, and ultrastructural characteristics. Am J Clin Pathol. 1998;110(5):615–21.

    CAS  PubMed  Google Scholar 

  72. Freudenthaler S, Hegenbart U, Schönland S, Behrens HM, Krüger S, Röcken C. Amyloid in biopsies of the gastrointestinal tract-a retrospective observational study on 542 patients. Virchows Arch. 2016;468(5):569–77.

    CAS  PubMed  PubMed Central  Google Scholar 

  73. Vanek J. Gastric submucosal granuloma with eosinophilic infiltration. Am J Pathol. 1949;25:405.

    Google Scholar 

  74. Garmpis N, Damaskos C, Garmpi A, Georgakopoulou VE, Sakellariou S, Liakea A, Schizas D, Diamantis E, Farmaki P, Voutyritsa E, Syllaios A, Patsouras A, Sypsa G, Agorogianni A, Stelianidi A, Antoniou EA, Kontzoglou K, Trakas N, Dimitroulis D. Inflammatory fibroid polyp of the gastrointestinal tract: a systematic review for a benign tumor. In Vivo. 2021;35(1):81–93.

    CAS  PubMed  PubMed Central  Google Scholar 

  75. Kang HC, Menias CO, Gaballah AH, Shroff S, Taggart MW, Garg N, Elsayes KM. Beyond the GIST: mesenchymal tumors of the stomach. Radiographics. 2013;33(6):1673–90.

    PubMed  PubMed Central  Google Scholar 

  76. Uche-Anya EN, Khan AS, Packey CD, Sung D, Sethi A. Gastric pancreatic heterotopia with pancreatic intraepithelial neoplasia. Gastrointest Endosc 2017;85(5):1098–1100. https://doi.org/10.1016/j.gie.2016.06.047.

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The authors agree to the fact that all biopsy procedures and surgical resections were performed after taking informed consent from respective patients as per the individual Institutional policies, which also includes consent for publishing the unidentified clinical images for publication or research purposes. The authors also declare no conflict of interest.

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Authors and Affiliations

  1. Department of Pathology, Al Sabah Hospital, Kuwait City, Kuwait

    Kaushik Majumdar

  2. Gastrointestinal and Hepatopathology Division, NHS University Hospital Coventry, Coventry, UK

    Ratnadeep Ganguly

  3. Department of Pathology, All India Institute of Medical Sciences, New Delhi, India

    Prasenjit Das

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  1. Kaushik Majumdar
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  2. Ratnadeep Ganguly
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  3. Prasenjit Das
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Editors and Affiliations

  1. Department of Pathology, All India Institute of Medical Sciences, New Delhi, India

    Prasenjit Das

  2. Department of Pathology, Al Sabah Hospital, Kuwait City, Kuwait

    Kaushik Majumdar

  3. Department of Pathology, All India Institute of Medical Sciences, New Delhi, India

    Siddhartha Datta Gupta

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Majumdar, K., Ganguly, R., Das, P. (2022). Benign Diseases of the Stomach. In: Das, P., Majumdar, K., Datta Gupta, S. (eds) Surgical Pathology of the Gastrointestinal System. Springer, Singapore. https://doi.org/10.1007/978-981-16-6395-6_8

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