Difference between revisions of "Gastric ulcer"

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'''Gastric ulcer''', also '''stomach ulcer''', is pathology of the [[stomach]] that is evident [[gross pathology|grossly]].  It can be benign of malignant.
'''Gastric ulcer''', also '''stomach ulcer''', is pathology of the [[stomach]] that is evident [[gross pathology|grossly]].  It can be benign or malignant.


==General==
==General==
*May be benign of malignant.
*May be benign or malignant.


Causes:
Causes:
Line 8: Line 8:
*[[Peptic ulcer disease]].
*[[Peptic ulcer disease]].
**[[Helicobacter gastritis]].
**[[Helicobacter gastritis]].
*[[Syphilis]].<ref name=pmid8343046>{{Cite journal  | last1 = Fyfe | first1 = B. | last2 = Poppiti | first2 = RJ. | last3 = Lubin | first3 = J. | last4 = Robinson | first4 = MJ. | title = Gastric syphilis. Primary diagnosis by gastric biopsy: report of four cases. | journal = Arch Pathol Lab Med | volume = 117 | issue = 8 | pages = 820-3 | month = Aug | year = 1993 | doi =  | PMID = 8343046 }}</ref>
*Other causes.


==Gross==
==Gross==
*Heaped (raised) edges - suggestive of [[gastric carcinoma|cancer]].
*Heaped (raised) edges - suggestive of [[gastric carcinoma|cancer]].
*Punched-out appearance with flat edges - suggestive of benign.
*Punched-out appearance with flat edges - suggestive of benign.
Notes:
*The classical teaching is to biopsy the ulcer edge, as the dictum is: the cancer is there; this dictum may not be true.<ref name=pmid22469743>{{Cite journal  | last1 = Lv | first1 = SX. | last2 = Gan | first2 = JH. | last3 = Ma | first3 = XG. | last4 = Wang | first4 = CC. | last5 = Chen | first5 = HM. | last6 = Luo | first6 = EP. | last7 = Huang | first7 = XP. | last8 = Wu | first8 = SH. | last9 = Qin | first9 = AL. | title = Biopsy from the base and edge of gastric ulcer healing or complete healing may lead to detection of gastric cancer earlier: an 8 years endoscopic follow-up study. | journal = Hepatogastroenterology | volume = 59 | issue = 115 | pages = 947-50 | month = May | year = 2012 | doi = 10.5754/hge10692 | PMID = 22469743 }}</ref>
*''Ulcer with clean base'' refers to nothing "in" the ulcer (depression); these may be benign or malignant.<ref name=pmid25312052>{{cite journal |authors=Gielisse EA, Kuyvenhoven JP |title=Follow-up endoscopy for benign-appearing gastric ulcers has no additive value in detecting malignancy: It is time to individualise surveillance endoscopy |journal=Gastric Cancer |volume=18 |issue=4 |pages=803–9 |date=October 2015 |pmid=25312052 |doi=10.1007/s10120-014-0433-4 |url=}}</ref>
**The term is within a popular classification of upper GI bleeding.<ref>URL: [https://www.endoscopy-campus.com/en/classifications/forrest-classification/ https://www.endoscopy-campus.com/en/classifications/forrest-classification/]. Accessed: 2022 January 11.</ref>
===Images===
<gallery>
Image:Adenocarcinoma of the stomach.jpg | Malignant ulcer of the stomach. (WC)
</gallery>
==Microscopic==
Features:
*Loss of the (gastric) epithelium.
*Vital reaction.
**Marked (acute) inflammation.
**Fibrin.
===Images===
<gallery>
Image: Stomach ulcer -- low mag.jpg | SU - low mag. (WC)
Image: Stomach ulcer -- intermed mag.jpg | SU - intermed. mag. (WC)
</gallery>


==Sign out==
==Sign out==
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*[[Helicobacter gastritis]].
*[[Helicobacter gastritis]].
*[[Gastric adenocarcinoma]].
*[[Gastric adenocarcinoma]].
*[[Cameron lesion]].
==References==
{{Reflist|1}}


[[Category:Stomach]]
[[Category:Stomach]]
[[Category:Diagnosis]]
[[Category:Diagnosis]]

Latest revision as of 16:39, 11 January 2022

Gastric ulcer, also stomach ulcer, is pathology of the stomach that is evident grossly. It can be benign or malignant.

General

  • May be benign or malignant.

Causes:

Gross

  • Heaped (raised) edges - suggestive of cancer.
  • Punched-out appearance with flat edges - suggestive of benign.

Notes:

  • The classical teaching is to biopsy the ulcer edge, as the dictum is: the cancer is there; this dictum may not be true.[2]
  • Ulcer with clean base refers to nothing "in" the ulcer (depression); these may be benign or malignant.[3]
    • The term is within a popular classification of upper GI bleeding.[4]

Images

  • Malignant ulcer of the stomach. (WC)

Microscopic

Features:

  • Loss of the (gastric) epithelium.
  • Vital reaction.
    • Marked (acute) inflammation.
    • Fibrin.

Images

  • SU - low mag. (WC)

  • SU - intermed. mag. (WC)

Sign out

Compatible with benign

A. STOMACH, BIOPSY:
- GASTRIC ANTRAL-TYPE MUCOSA WITH EDEMA, FOCALLY PROMINENT SMOOTH MUSCLE, 
  ACTIVATED FIBROBLASTS, A MILD INCREASE OF EOSINOPHILS, AND FIBRIN -- 
  COMPATIBLE WITH NEARBY ULCER.
- NEGATIVE FOR HELICOBACTOR-LIKE ORGANISMS.
- NEGATIVE FOR INTESTINAL METAPLASIA.
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY.

See also

References

  1. ↑ Fyfe, B.; Poppiti, RJ.; Lubin, J.; Robinson, MJ. (Aug 1993). "Gastric syphilis. Primary diagnosis by gastric biopsy: report of four cases.". Arch Pathol Lab Med 117 (8): 820-3. PMID 8343046.
  2. ↑ Lv, SX.; Gan, JH.; Ma, XG.; Wang, CC.; Chen, HM.; Luo, EP.; Huang, XP.; Wu, SH. et al. (May 2012). "Biopsy from the base and edge of gastric ulcer healing or complete healing may lead to detection of gastric cancer earlier: an 8 years endoscopic follow-up study.". Hepatogastroenterology 59 (115): 947-50. doi:10.5754/hge10692. PMID 22469743.
  3. ↑ Gielisse EA, Kuyvenhoven JP (October 2015). "Follow-up endoscopy for benign-appearing gastric ulcers has no additive value in detecting malignancy: It is time to individualise surveillance endoscopy". Gastric Cancer 18 (4): 803–9. doi:10.1007/s10120-014-0433-4. PMID 25312052.
  4. ↑ URL: https://www.endoscopy-campus.com/en/classifications/forrest-classification/. Accessed: 2022 January 11.
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