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Histopathology report shows Chronic gastritis. Relation to melena? What is antrum gastritis?

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Gastroenterologist
Practicing since : 1962
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Question
Dear Doc
My Histopathology report 19 XXXXXXX 2013 is:
Quote
Diagnosis
Gastric biopsies: Chronic gastritis
Gross Description
The specimen is received in formalin, labelled with patient's data and designated ' gastric biopsy'. It consists of 6 pieces of tissues measuring 0.2cm to 0.3cm in greatest dimension. (A1(A,B antrum inked blue, C -insura inked yellow, D, E -lesser curve inked green) A2(F-greater curve inked blue); no reserve)
Microscopic Description
A total of four pieces of specialised acid secreting type, and two of transistional type gastric mucosa received, showa mild chronic inflammatory cell infiltrate in the lamina propia. No Helicobacter pylori organisms are identified, and there is no evidence of ulceration, intestinal metaplasia or dysplasis.

Unquote

Questions
1. What is this all all about in relation to melena?
2. Does this say anything about antrum gastritis?
Posted Sun, 18 Aug 2013 in Digestion and Bowels
 
 
Answered by Dr. Charles S Narasi 13 hours later
Hello, XXXXX,
Tha nk you for the report.
Essentially what it shows is "Mild Chronic Gastritis".
Total of six biopsies were taken from different parts
of the stomach including the lower part or the "Antrum ".
I believe specimen labeled "B" inked blue.
Remember the classification that I mentioned before.
Yours is Mild category. Can this cause "Melena " or black
spots in the stool , it is possible at some point the degree
of inflammation might have been more than mild and at
that time you could have had slow bleed.
That is my conclusion and you can discuss further with
your doctor who did the scope and biopsies.
I wish you good luck.
Above answer was peer-reviewed by
 
Follow-up: Histopathology report shows Chronic gastritis. Relation to melena? What is antrum gastritis? 7 hours later
Thanks Doc XXXXXXX
The endoscopist/surgeon says cannot find anything except mucosa raw and showed me photos. (suspect cannot see 'water melon ' markings that you mentioned or bleeding source). That doc says whether to investigate the bile duct(?) via endoscopic CT(?). When asked about the antrum gastritis, that doc also says the patho report would show if any abnormalities but stated no dysplasia nor metadysplasia. That doc says that patho report is good.

Two other family physicians say that my full blood count, alpha, CK and without anaemia are normal; any abnormalities would show up in blood markers as well.

Sometimes I do bite my tongue while eating,( you mentioned about gum bleeding)

What would you say if you were me?
 
 
Answered by Dr. Charles S Narasi 9 hours later
Hello, XXXXX,
I agree with your endoscopist that it is good news that you don't
have dysplasia or metaplasia which are pre-cancerous.
Your blood count is normal which is good.
If I were you, I would stop worrying and lead a normal life
and enjoy.
Above answer was peer-reviewed by
 
Follow-up: Histopathology report shows Chronic gastritis. Relation to melena? What is antrum gastritis? 26 minutes later
Thanks Doc
Just being responsible and take care of oneself.

God bless
 
 
Answered by Dr. Charles S Narasi 1 hour later
Dear XXXXXX,
I couldn't agree with you more !!
Have a wonderful day .


Above answer was peer-reviewed by
 
Follow-up: Histopathology report shows Chronic gastritis. Relation to melena? What is antrum gastritis? 38 hours later
Dear Doc
One way to enjoy is to keep learning.

Read about role of pathologist. When they look at cell structure ,in histology ,especially parietal cells ; would they report the extent of damage if they see extensive damage?

That would be abnormalities as parietal cells are implicated in AG.
 
 
Answered by Dr. Charles S Narasi 8 hours later
Hello, XXXXX,
There are a number of different types of cells in the stomach.
There are fundic glands, body of the stomach glands and pyloric
area glands. Some produce mucus . The antral area glands
produce gastrin , hormone. Parietal cells as you know produce
hydrochloric acid. There is also cells that produce intrinsic factor
which is needed for absorption of vitamin B-12 that is in the area of antrum.
Pathologists can see this under the high power magnification of the
microscope , although a very detailed information van only be seen
under electron microscopy. Damages can be seen under lower magnification.
I am not a pathologist but I have given you some basics.
Above answer was peer-reviewed by
 
Follow-up: Histopathology report shows Chronic gastritis. Relation to melena? What is antrum gastritis? 35 minutes later
Thanks Doc
What are the cells within lamina propia ?
 
 
Answered by Dr. Charles S Narasi 1 hour later
Hello, XXXXX,
The inner lining of the stomach or the mucosa contains
three layers. The epithelium ,Lamina propria and muscularis
mucosa. Different parts of the stomach have different cells.
Above answer was peer-reviewed by
 
Follow-up: Histopathology report shows Chronic gastritis. Relation to melena? What is antrum gastritis? 1 hour later
Thanks Doc

What is meant when a pathologist says
'... show a mild chronic inflammatory cell infiltrate in the lamina propia...' ?

Does it refer to lymphoplasmacytic infiltrates?
 
 
Answered by Dr. Charles S Narasi 2 hours later
Hello,
That is correct. Inflammatory cells usually consist of
Lymphocytes , plasma cells , may be macrophages
and neutrophils. All signs of inflammation.
Above answer was peer-reviewed by
 
Follow-up: Histopathology report shows Chronic gastritis. Relation to melena? What is antrum gastritis? 6 hours later
Thanks Doc


does that say foci of gland infiltration/damage?

also :
does it says deep or diffuse infiltrates?
 
 
Answered by Dr. Charles S Narasi 11 hours later
Yes, lamina propria shows infiltrates of inflammation which
is "Mild".
Above answer was peer-reviewed by
 
Follow-up: Histopathology report shows Chronic gastritis. Relation to melena? What is antrum gastritis? 2 hours later
Could your answer be be clearer; the lymphoplasmacytic infiltrates : is it deep or diffuse with foci of gland infiltration/damage??

Mild may not be deep or diffuse and foci of gland infiltration/damage.

 
 
Answered by Dr. Charles S Narasi 44 minutes later
Dear XXXXX,
I did not take a look at the slide. Pathologist did.
I can only comment on the report. It does not say
whether the changes were diffuse , scattered etc.
You may want to talk to the doctor and get clarification
about the final findings.
Wish you well.
Above answer was peer-reviewed by
 
Follow-up: Histopathology report shows Chronic gastritis. Relation to melena? What is antrum gastritis? 42 minutes later
Thanks Doc
It is good to learn new things using commonsense in deduction.

According to a source of pathology's standards on the web, there must be sufficient monuclear infiltrates before gastritis be diagnosed.

The question relevant here is whether there is foci of gland infiltration and damage. The key words are :gland infiltration/damage.

My sense tells me that given my full blood count including lymphocytes etc etc are normal, that being the case, one would think there is mild impact ie mild lymphocytic infiltration but not remarkable clinically . There is no severe or remarkable damage or destruction to the oyntic gland.

What is your take?



 
 
Answered by Dr. Charles S Narasi 1 hour later
Dear XXXXX,
I agree with you that the pathology findings have little
clinical significance in your case.
Have a nice day .
Above answer was peer-reviewed by
 
Follow-up: Histopathology report shows Chronic gastritis. Relation to melena? What is antrum gastritis? 5 hours later
Thanks Doc
So you think there is there is no evidence of destruction to the oxyntic glands in lamina propria?
 
 
Answered by Dr. Charles S Narasi 12 hours later
Dear XXXXX,
Yes , I would think so .
Above answer was peer-reviewed by
 
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