Page 411 - Concise Pathology for Exam Preparation ( PDFDrive )

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396 SECTION II Diseases of Organ Systems
Q. Classify gastritis.

Ans. Gastritis is classified based on
1. The inflammatory cell type and duration:
(a) Acute gastritis (infiltration by neutrophils)
(b) Chronic gastritis (infiltration by lymphocytes and plasma cells)
- Helicobacter pylori–induced gastritis
- Autoimmune gastritis
- Others
2. The region involved
(a) Antral gastritis
(b) Corpus gastritis
(c) Pan gastritis
3. The presence of premalignant changes
(a) Nonatrophic
(b) Atrophic (may progress to carcinoma)

Q. Describe the aetiology, morphology and clinical presentation of
acute gastritis.
Ans. Acute transient inflammation of gastric mucosa is labelled acute gastritis.

Aetiology

Acute and chronic gastritis occur when there is a dominance of damaging factors or break-
down of gastroduodenal defence mechanisms.

Clinical Features
• Asymptomatic
• Epigastric pain of variable severity, nausea and vomiting
• Mucosal erosion/ulceration may occur with severe gastritis leading to haemorrhage,
haematemesis and melena
• Gastropathy is a group of disorders of diverse aetiology (alcohol, NSAIDs, bile, stress)
which cause gastric dysfunction and may present like acute gastritis.

Morphology

• In mild gastritis, no significant change is seen.
• Mucosal erosion/ulceration may occur with severe gastritis leading to haemorrhage
(acute erosive gastritis).

Q. Describe the aetiology, morphology and complications of chronic
gastritis.
Ans. Chronic inflammation of gastric mucosa and submucosa results in mucosal atrophy,
epithelial metaplasia, dysplasia and predisposition to development of carcinoma without
accompanying mucosal erosion.

Aetiology
• Infection:
• H. pylori is a gastric pathogen that has a strong causal association with gastritis and
peptic ulcer disease.
• Chronic infection with this pathogen is known to be associated with gastric adeno-
carcinoma and low-grade gastric lymphoma.
• It is a Gram-negative, noninvasive, non-sporing and rod-shaped bacteria.
• H. pylori mediated gastritis is the result of combined influence of bacterial enzymes
and toxins with release of toxic chemicals from recruited neutrophils.

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