A....B....C....of Endoscopic Gastric

Biopsies

Dr. S. Rajendiran

Sri Ramachandra University

Porur, Chennai, India

with ANSWERS

Case 1

• 60 year male

• Upper GI discomfort for the past 7

months

• Underwent EGD - erosions in the

antrum

• Fundic and antral biopsies taken

Corpus Antrum

Ch. Inflammation Severe

Neutrophilic activity Moderate

H. pylori Severe

Intestinal metaplasiaMild

Atrophy

Case 1

Others:

Nil

Case 1 - Diagnosis

Case 2

• 38 year male

• Pain in the epigastrium

• History of renal transplant and

immunosuppression

• Underwent EGD - irregular

erythematous areas in the body

• Fundic and antral biopsies taken

What do you see?

Corpus Antrum

Ch. InflammationMild

Neutrophilic activity

H. pylori

NilIntestinal metaplasia

Atrophy

Case 2

Others:

CMV Inclusions Present

Case 2 - Diagnosis

Case 3

• 45 year female

• Unexplained megaloblastic anemia for

the past 5 months (Hb. 8 gms%)

• Underwent EGD - Gastric erosions,

more in the body with relative antral

sparing

• Fundic and antral biopsies taken

Corpus Antrum

Ch. Inflammation Mild

Nil

Neutrophilic activityNil

H. pylori

Intestinal metaplasia Moderate

Atrophy Marked

Case 3

Others:

Endocrine cell

hyperplasia

Pyloric metaplasia

Case 3 - Diagnosis

Case 4

• 56 year female

• H/O malabsorbtion present 5 months.

Duodenal biopsy showed evidence of

celiac disease

• Now presented with dyspepsia

• Underwent EGD - Irregular nodularity

• Fundic and antral biopsies taken

Corpus Antrum

Ch. Inflammation

Nil

Severe

Neutrophilic activity

NilH. pylori

Intestinal metaplasia

Atrophy

Case 4

Others:

Increased theliolymphocytes

(40%)

Case 4 - Diagnosis

Case 5

• 66 year female

• Now presented with heart burn - 4

months

• H/O Rheumatoid Arthritis +

• Underwent EGD - pre-pyloric mucosal

ulcerations

• Fundic and antral biopsies taken

Corpus Antrum

Ch. Inflammation

Nil

Neutrophilic activity

H. pylori

Intestinal metaplasia

Atrophy

Case 5

Others: 1. Villiform surface changes

2. Edema of lamina propria

3. Muscularis mucosa Hyperplasia with

ext. in to LP

Case 5 - Diagnosis

Case 6

65, male, subtotal gastrectomy,

? ca

Granulomatous gastritis

Case 7

55, male, GE junction polyp ?

ca

Gastric fundic gland

polyp

Case 8

62, female, multiple gastric

polyps

PJ polyp

Case 9

50, male, gastric polyp

Hyperplastic polyp with xanthoma

Case 10

57, female, gastric growth

biopsy

Poorly diff. ca. with focal signet cells

A....B.....C....of

Gastritis