Histological gastric mucosal findings in systemic diseases
| Uraemic gastropathy | Foveolar hyperplasia. Multinucleated, vacuolated or fragmented parietal cells possibly resulting from long-term steroid therapy and the trophic effects of hypergastrinaemia. Mucosal calcifications. In the presence of Helicobacter pylori, a mixture of findings can be present. |
| Mastocytosis | Mucosal infiltrates can be focal and subtle (multiple biopsies are suggested). The infiltrate consists of small (predominant subepithelial) clusters of rounded, medium-sized cells with pale eosinophilic cytoplasm; egg-shaped and spindle-shaped cells with scanty cytoplasm may be featured. Special stains (CD117, tryptase and CD25) are necessary to recognise, characterise and quantify the mast cells infiltrate. |
| IgG4-related gastritis | Bottom-heavy plasmacytosis is a distinct feature of IgG4-GID. Non-atrophic oxyntic mucosa features a dense plasma cell infiltrate of the lamina propria. |
| Sarcoidosis | Granulomatous epithelioid infiltrate (Crohn’s disease is confidently excluded by the occurrence of granulomas outside the gastrointestinal tract). |
GID, gastrointestinal disease.