Reactive Gastropathy

Classification	D
External resources	eMedicine: article/1962893;

Reactive gastropathy
	Micrograph of a reactive gastropathy. H&E stain.
Specialty	Pathology, gastroenterology

Reactive gastropathy, chemical gastropathy also called gastritis of « C type » or "chemical gastritis"^[1] is an abnormality in the stomach caused by chemicals, e.g. bile, alcohol, and characteristically has minimal inflammation.

Cause

Reactive gastropathy has a large number of causes, including:

Alcohol use disorder.
Bile reflux, such as may be seen post-Billroth II.
NSAIDs.

Diagnosis

Reactive gastropathy, is characterized histologically by:^[2]
- Foveolar hyperplasia (black arrow), as a tortuosity in the "neck" region of the gastric glands.
- Scant or minimal inflammatory cells (white arrow), i.e. lack of large numbers of neutrophils and plasma cells..
- Smooth muscle hyperplasia in the lamina propria (in black oval).

The diagnosis is by examination of tissue, e.g. a stomach biopsy.

Low mag.
High mag.

Relation to gastritis

Reactive gastropathy is morphologically distinct entity^[3]^[4] that can be separated from gastritis, which by definition has a significant inflammatory component.

As a reactive gastropathy may mimic a (true) gastritis symptomatically and visually in an endoscopic examination, it may incorrectly be referred to as a gastritis. Even aware of the underlying etiology of the pathologic process, e.g. NSAID use, the label "chemical gastritis" is applied to a chemical gastropathy.

References

↑ "Chronic gastritis—a pathogenesis approach". The Journal of Pathology 40 (154): 113–24. 1988. doi:10.1002/path.1711540203. PMID 3280764.
↑ Genta, RM (Nov 2005). "Differential diagnosis of reactive gastropathy". Seminars in Diagnostic Pathology 22 (4): 273–83. doi:10.1053/j.semdp.2006.04.001. PMID 16939055.
↑ Pashankar, DS; Bishop, WP; Mitros, FA (Nov 2002). "Chemical gastropathy: a distinct histopathologic entity in children". Journal of Pediatric Gastroenterology and Nutrition 35 (5): 653–7. doi:10.1097/00005176-200211000-00012. PMID 12454581.
↑ Dixon, MF; O'Connor, HJ; Axon, AT; King, RF; Johnston, D (May 1986). "Reflux gastritis: distinct histopathological entity?". Journal of Clinical Pathology 39 (5): 524–30. doi:10.1136/jcp.39.5.524. PMID 3722405.

External links

Reactive gastropathy - surgical pathology criteria (stanford.edu).

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[1] "Chronic gastritis—a pathogenesis approach". The Journal of Pathology 40 (154): 113–24. 1988. doi:10.1002/path.1711540203. PMID 3280764.

[pmid16939055-2] Genta, RM (Nov 2005). "Differential diagnosis of reactive gastropathy". Seminars in Diagnostic Pathology 22 (4): 273–83. doi:10.1053/j.semdp.2006.04.001. PMID 16939055.

[pmid12454581-3] Pashankar, DS; Bishop, WP; Mitros, FA (Nov 2002). "Chemical gastropathy: a distinct histopathologic entity in children". Journal of Pediatric Gastroenterology and Nutrition 35 (5): 653–7. doi:10.1097/00005176-200211000-00012. PMID 12454581.

[pmid3722405-4] Dixon, MF; O'Connor, HJ; Axon, AT; King, RF; Johnston, D (May 1986). "Reflux gastritis: distinct histopathological entity?". Journal of Clinical Pathology 39 (5): 524–30. doi:10.1136/jcp.39.5.524. PMID 3722405.