7. Pathology of Gastric Diseases Flashcards
Anatomy of the stomach: what are the various segments of the stomach? where is each located?
(Jullet don’t laugh at me!)
Cardia: area around LES
Fundus: comes after cardia; the first bulge
Body: after Fundus, the main part of the stomach
Antrum: the last part, just prior to the pylorus
Cardia: what kind of cells?
mucous cells
Fundus and body: what kinds of cells? what do they produce?
Parietal cells: produce acid (HCl)
Chief cells: produce pepsinogen
Mucosa of the fundus/body = oxyntic epithelium (acid-producing)
where is the incisura located? what section is distal to it?
the notch on the lesser curvature. distal to this is the Antrum
Antrum: what kinds of glands? what do they produce?
mucous glands (mucin)
G cells (gastrin)
Name the different areas of this stomach (E, C, F, P, D)

E = esophagus
C = cardia
F = fundus
P = pylorus/antrum
D = duodenum
What are rugae? what is teh pathology if they are flattened? what if they are hypertrophied?
the folds in the fundus/body. all the mucosa is in the rugae.
If flattened, atrophic gastritis
If hypertrophied, ZE syndrome
Name the 4 layers of the gastric wall in this pic.

Mucosa
submucosa
Muscularis propria
serosa (very thin at bottom)
There is gastric mucosa all over the stomach. what part of it is the same everywhere, and what part varies by region?

Foveolar Compartment (the superficial epithelium) is the same everywhere. (Kind of like the Fc region of antibodies)
The Glandular compartment varies by region:
Cardia: mucous-secreting epit.
Fundus/body: oxyntic/acid-producing epit.
Pylorus/antrum: mucous-secreting epit.
What is this an image of? What are the notable features?

Normal histo: foveolar compartment.
Note mucin-secreting cells w nuclei at bottom
“Gastric foveolar type epithelium”
He mentioned we should be able to recognize this ;)
What kind of mucosa is this? What is produced here?

Oxyntic mucosa of fundus and body.
Acid, pepsin produced here.
What is this a picture of? What are the pink cells producing? what are the blue cells producing?

Oxyntic glandular compartment.
Pink cells: granular cytoplasm, producing HCl
Blue cells: producing pepsin
This may be gastritis: not sure why.
Where in the stomach does this come from? what are the cells producing?

Antrum.
Mucin-producing mucosa
Where in the stomach is this taken from? What kinds of glands are these?

Antrum/pyloric area
These are typical of antral mucin-producing glands
What are the 5 components of the gastric mucosal protective barrier?
- Mucus secretion
- Bicarb secretion into mucus
- Epithelial barrier (tight junctions)
- Mucosal blood flow
- Prostaglandin synthesis
Broadly, what are the categories of stomach pathologies?
- Congenital lesions
- Gastritis and ulcers
- Neoplasms
Gastritis is divided into Acute and Chronic. Two types of Acute Gastritis, and two types of Chronic?
Acute: Hemorrhagic, Erosive
Chronic: H pylori, Autoimmune
Acute Gastritis: definition? morphology?
Acute mucosal injury usually of a transient nature which subsides if the inciting stimulus is removed. Morphologically characterized by mucosal injury and regenerative changes in the absence of significant inflammation in lamina propria.
Acute gastritis: common causes?
NSAIDs, EtOH
ingestion of acid or alkali
heavy smoking
severe hypotension/shock
severe stress (trauma, burns)
What’s this? What is notable?

Mucosa of acute gastritis.
note the multiple hemorrhages and several defects in the mucosa
Stress Ulcer: definition? What may be the cause?
Defined as the loss of tissue such that the defect extends into the submucosa.
Acute gastritis may progress to ulcer
May be due to trauma, burns, shock, sepsis
May result in life-threatening hemorrhage
What is this a picture of? What are the notable features?

Acute Erosive Gastritis
Note: at top, fibrin, neutrophils, damaged mucosa. Some of the epithelium has been destroyed by erosion
Underlying glands have reacted to stress and multiplied
Note especially: exudate, partial destruction of the mucosa
What is this picture? What is notable?

Chronic Gastritis.
Note PMN and plasma cell infiltrate in lamina propria (this is the main feature of chronic gastritis)
What is the diagnostic criterion for chronic gastritis?
increased chronic inflammatory cells in the lamina propria.



































