Gastric Mucosal Siderosis

Deposition of iron within the gastric mucosa is referred to as gastric siderosis or hemosiderosis.

Siderosis may present as dark brown deposits. A positive iron stain (Prussian blue) confirms the identification.

Differential diagnosis:

(1) hereditary hemochromatosis

(2) alcohol abuse

(3) iron medications

(4) multiple blood transfusions

(5) cirrhosis with esophageal varices

Primary iron deposits	Minor Iron Deposits	Other Findings	Pattern
patchy, stromal cells and macrophages	epithelial cells	gastritis, mucosal hemorrhages	A
patchy, extracellular	blood vessels, macrophages, epithelial cells	gastritis, reactive gastropathy	B
diffuse, within antral and fundic glandular epithelial cells (deep gastric glands)			C

Pattern A (nonspecific) may be associated with Helicobacter pylori, iron medications or other causes.

Pattern B (iron pill gastritis) is usually associated with iron medications.

Pattern C (gastric glandular siderosis) is usually associated with hemochromatosis

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