Granulomatous Gastritis
Definition
- 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
