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  • Surgical Pathology Criteria

    Granulomatous Gastritis


    • Gastric inflammation containing granulomas

    Diagnostic Criteria

    • Granulomas usually superficial
      • May be seen to be transmural on resection specimens
      • Usually non-necrotic
    • Variable acute and chronic inflammation
    • May be focal or diffuse
      • Most common in antrum
    • Various causes – should be ruled out and addressed in report
      • Crohn disease is most common cause of cases
        • Diagnosis usually already known from intestinal evaluation
      • Sarcoidosis may present without thoracic disease
      • Role of Helicobacter is controversial
        • Some report it as the most common cause after above excluded
      • Foreign body reaction
        • Polarization may help to exclude
        • May be due to drugs, including antacids
      • Infection must always be ruled out
        • Mycobacteria
        • Fungi
        • Parasites
      • Common variable immunodeficiency
        • Rare granulomas in stomach
      • Granulomas may be seen adjacent to gastric neoplasms
      • Isolated, idiopathic – very rare, if it exists at all
        • Has been termed Isolated Granulomatous Gastritis (IGG)
        • Primarily reported in adults
    • Endoscopic appearance ranges from non-specific minor changes to thickened mucosal folds with outlet obstruction

    Robert V Rouse MD
    Department of Pathology
    Stanford University School of Medicine
    Stanford CA 94305-5342

    Original posting : September 9, 2009

    Classification / Lists

    Gastritis / Gastropathy


    • 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 Apr;20(4):462-70.
    • Maeng L, Lee A, Choi K, Kang CS, Kim KM. Granulomatous gastritis: a clinicopathologic analysis of 18 biopsy cases. Am J Surg Pathol. 2004 Jul;28(7):941-5.
    • Owen DA. Gastritis and carditis. Mod Pathol. 2003 Apr;16(4):325-41
    • Srivastava A, Lauwers GY. Pathology of non-infective gastritis.Histopathology. 2007 Jan;50(1):15-29.
    Printed from Surgical Pathology Criteria:
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