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home - Stomach - Gastritis and Gastropathy - Granulamtous Gastritis Written by Dr Sebastian Zeki

Granulamtous Gastritis

Granulomatous gastritis A granuloma (granulomatous inflammation) is an organized aggregation of combined histiocytic, lymphocytic, and plasma cell infiltrate. When this organized collection of cells is identified in the stomach, it is referred to as granulomatous gastritis.It is classified as one of the chronic gastritides and can be subclassified into infectious, non-infectious, and idiopathic categories. Causes:Crohn's disease (55%)- rare macroscopic involvement, 75% microscopic of which 2/3rds have mucosal granulomas.Sarcoidosis (21%) - 5 to 10% with systemic sarcoidosis have subclinical involvment.H. pylori- granulomas disappear after treatment.MALT lymphoma (5 %).Peptic ulcer complication (5 %).Hypertrophic gastropathy and chronic active gastritis (2 %). Granuloma types : Caseation necrosisWell defined epithelioid granulomas with a circumscribed solid appearance - commonly seen in sarcoidosis.Non-caseating granulomas - seen with Helicobacter pylori and Crohn's disease.Necrotizing granulomas- especially if associated with vasculitis, suggest Wegener's granulomatosis. Additional infectious causes of granulomatous gastritisTuberculosis, tertiary syphilis (gumma), Whipple's disease, various fungal infections, anisakiasis, taeniasis, other parasitic worms and schistosomes.Additional non-infectious causes of granulomatous gastritisTumors (upper GI tract adenocarcinoma and lymphoma), vasculitides (eg, Wegener's granuloma-tosis), drugs (eg, cocaine and carbimazole), xanthogranulomatous gastritis, foreign body reactions to stomach contents within an ulcer repair zone or to surgical material, Langerhans cell histiocyto-sis (which is more common in childhood), and chronic granulomatous disease (which is also more common in childhood and adolescence).Idiopathic granulomatous gastritis The clinical importance of idiopathic granulomatous gastritis is uncertain is usually associated with an infectious etiology which may be fungal or bacterial (Mycobacterium tuberculosis, atypical mycobacteria, histoplasmosis). Written by Dr Sebastian Zeki

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