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Autoimmune gastritis
Haematoxylin & Eosin (H&E)
33 years
Vitamin B12 deficiency and megaloblastic anemia. Infection with Enterobius vermicularis. History of ameba infection. Clinical questions: (Autoimmune) gastritis?
Gastric biopsies showing severe chronic inflammation. There is extensive atrophy of oxyntic glands making the mucosa resembling the antrum. In addition, a small focus of complete intestinal metaplasia is present.
Immunohistochemical stains (synaptophysin and chromogranin A) hightlight micronodular hyperplasia of neuroendocrine cells. In addition, single fragments show positivity for gastrin, indicating that they actually have been taken from the antrum. Additional biopsies from the antrum showed fovealar hyperplasia without significant inflammation. There was no atrophy present.
In autoimmune gastritis the mucosa of the antrum is spared. Therefore, biopsies should be taken separately from the antrum and corpus / fundus if there is any suspicion of autoimmune gastritis, since highly atrophic oxyntic mucosa often resembles antrum-type mucosa.
Katharina Glatz, University of Basel
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