There are several different types of hyperplastic gastropathy which can often be distinguished based on the anatomic and pathologic features.
General features of hyperplastic gastropathy:
(1) large or giant rugal folds
(2) hyperplasia of the mucosa, defined as a thickness > 1.5 mm
Descriptors:
(1) localized vs diffuse
(2) involvement of the body and greater curvature of the stomach vs antrum
(3) changes in the foveolar epithelium (hyperplasia, normal or atrophy)
(4) changes in the specialized glandular epithelium (hyperplasia, normal or atrophy)
(5) associated findings
(5a) hypersecretory for gastric acid with peptic ulcer
(5b) protein loss with hypoproteinemia and hypoalbuminemia
(5c) changes in serum gastrin
(5d) relation to stoma, ulcer, anastomosis or partial gastrectomy
(5e) parietal cell hyperplasia
Location |
Foveolar Cells |
Specialized Glands |
Other |
Type |
body and greater curvature; not in antrum |
normal |
hyperplastic, with increased parietal cells |
peptic ulcer, serum gastrin elevated |
Zollinger- Elison |
body and greater curvature; not in antrum |
hyperplastic |
atrophic |
protein loss |
Menetrier's |
body and greater curvature; not in antrum |
hyperplastic |
hyperplastic; parietal cells not increased |
peptic ulcer, gastrin not elevated |
hypertrophic hypersecretory |
body and greater curvature; not in antrum |
hyperplastic |
hyperplastic to mild atrophy; parietal cells not increased |
protein loss, occasional peptic ulcer |
hypertrophic hypersecretory with protein loss |
localized, may involve the antrum |
hyperplastic |
|
adjacent to stoma, ulcer, anastomosis, etc |
localized hypertrophy |
Specialty: Gastroenterology