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Autoimmune gastritis: novel clues to histological diagnosis.
MedLine Citation:
PMID:  23277173     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
AIMS: : To compare the histological features of a consecutive biopsy series of autoimmune gastritis (AIG) with other forms of chronic gastritis to identify morphological clues to the diagnosis.
METHODS: : Morphological features in gastric biopsies were examined in 42 prospectively identified patients with AIG without concomitant neoplasia (n = 184 biopsies), 50 normal controls (NGB; n = 118 biopsies), 52 Helicobacter associated gastritis (HPG; n = 123 biopsies), 16 multifocal atrophic gastritis (MAG; n = 62 biopsies) and 50 chronic pangastritis without defined cause (CG; n = 117 biopsies).
RESULTS: : In AIG, inflammation was characterised by lymphocyte infiltration into the epithelium (98%), basal lymphoid aggregates (82.7%), basal predominance (59.6%), eosinophil infiltration [mean 34.5/high power field (HPF), >30 eosinophils/HPF in 46.1%] and neutrophil infiltration (44.2%). Architectural abnormality was characterised by muscularis mucosae thickening (92.9%) and gland irregularity (86.5%). Pancreatic metaplasia was identified in 21.2% of cases. Compared to NGB, HPG, MAG and CG, AIG displayed more eosinophil infiltration (p < 0.001) and more frequent lymphocyte infiltration of the epithelium, basal predominant inflammation and pancreatic acinar metaplasia (all p < 0.05).
CONCLUSIONS: : Basal predominance of inflammation, lymphocyte infiltration into gland epithelium, prominent eosinophils, architectural irregularity and muscularis mucosae thickening are common in AIG and are helpful when biopsy site and/or clinical history is uncertain.
Authors:
Mark Bettington; Ian Brown
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pathology     Volume:  45     ISSN:  1465-3931     ISO Abbreviation:  Pathology     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0175411     Medline TA:  Pathology     Country:  England    
Other Details:
Languages:  eng     Pagination:  145-9     Citation Subset:  IM    
Affiliation:
*Envoi Specialist Pathologists †The Queensland Institute of Medical Research, Brisbane, Queensland, Australia.
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