Acute Gastritis 

(endoscopy)

Mild: May see scattered neutrophils in the epithelium or within glands

Moderate/Severe: loss of superficial epithelium as deep as the lamina propria, with neutrophilic infiltrate in the mucosa and a fibrinous exudate in the lumen

Activity

Either in acute or chronic gastritis

 neutrophils within the epithelium, above the basement membrane

Acute Gastritis

(Clinical Pte)

• A transient process, presenting with variable degrees of epigastric pain, nausea and vomiting
  • May also be asymtomatic
• Severe cases are associated with ulceration, with hemorrhage, hematemesis, and melena. Rarely, can cause severe blood loss.

Chronic Gastritis 

(endoscopy)

Antral mucosa is typically erythematous, with a coarse or nodular appearance (antral gastritis)

• inflammatory infiltrate is intense, the rugal folds may be thickened, mimicking an infiltrative lesion

Chronic Gastritis

(microscopic)

• Organisms (h.pylori) seen in over surface & neck of antrum
• Neutrophils intraepithelium or in pits --> pit abscesses. 
• Lymphocytes and plasma cells in lamina propia --> germinal centers

Chronic Gastritis 

(Clinical presentation)

• Nausea, upper abdominal discomfort, occasional vomiting
• H. pylori diagnosis
• complicated by peptic ulcer disease, as well as dysplasia (adenoma) and carcinoma (arising out of areas of intestinal metaplasia in multifocal atrophic gastritis) and lymphoma.

Autoimmune Chronic Gastritis

(endoscopy)

• Marked thinning of body and fundus mucosa with loss of rugal folds
• Damage to antrum and cardia is typically absent or mild

Autoimmune Chronic Gastritis

(microscopic)

• Loss of parietal cells and chief cells 
• Intestinal metaplasia may be present, with goblet cells
• Antral endocrine hyperplasia, paralleling the degree of mucosal atrophy
• Mixed mononuclear inflammatory infiltrate (lymphocytes, macrophages, some plasma cells)

Chronic Gastritis Germinal Centers

Chronic Gastritis Pit Abscesses

Gastric Hyperplastic/Inflammatory Polyp

Gastric Adenoma

Gastric Carcinoma-Intestinal Type

Gastric Carcinoma-Intestinal Type (2)

Gastric Lymphoma