Surgical Pathology Criteria

Gastric Antral Vascular Ectasia

Differential Diagnosis

Portal Hypertensive Gastropathy Gastric Antral Vascular Ectasia
Involves fundus and corpus Involves antrum
Endoscopic diffuse changes Endoscopic longitudinal stripes
Secondary to cirrhosis May be associated with cirrhosis
No microthrombi Microthrombi characteristic
No fibromuscular change or hyalinization in lamina propria Fibromuscular hyperplasia with hyalinization of lamina propria

Atrophic Autoimmune Gastritis Gastric Antral Vascular Ectasia
Lacks endoscopic stripes Endoscopic watermelon stripes
Unremarkable capillaries Prominent capillary ectasia
No microthrombi Microthrombi characteristic
No fibromuscular change or hyalinization in lamina propria Fibromuscular hyperplasia with hyalinization of lamina propria
Atrophic autoimmune gastritis may be associated with GAVE, so no features of AAG exclude the diagnosis of GAVE.

Dieulafoy Lesion / Caliber Persistent Artery Gastric Antral Vascular Ectasia
Abnormaly large vessel in lamina propria Capillary ectasia and thrombosis in lamina propria
No specific submucosal lesion Submucosal vessels may be tortuous
No microthrombi Microthrombi characteristic
Lamina propria normal except for large vessels Fibromuscular hyperplasia with hyalinization of lamina propria

 

  • Similar histologic features may be seen in gastric hyperplastic polyps but clinical correlation will avoid any problems
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