Chemical Gastritis / Reactive Gastropathy

Definition

Foveolar hyperplasia and expansion
- Produces corkscrew or serrated appearance of elongated crypts
Usually involves antrum
- May involve body if post-antrectomy
Regenerative changes in foveolar cells
- Enlarged and hyperchromatic nuclei
- Prominent nucleoli
- Decreased cytoplasmic mucin
Parietal cells preserved in glands
Minimal to absent neutrophilic and lymphocytic inflammation
- Acute inflammation without chronic occasionally seen
  - May be difficult to sort out if complicated by Helicobacter
- Eosinophils may be present
Edema
Congestion
Muscle fibers may be seen in the lamina propria
- Scant inflammation
- Similar to ischemic injury
May form erosions and ulcers
- Inflammation restricted to the ulcer
- Surrounding mucosa has little or no inflammation
Hemorrhage and necrosis of superficial mucosa may be seen
- Frequently linear and antral

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