Dr rajendiran slide seminar with ANSWER KEYS
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Transcript of Dr rajendiran slide seminar with ANSWER KEYS
A....B....C....of Endoscopic Gastric
Biopsies
Dr. S. Rajendiran
Sri Ramachandra University
Porur, Chennai, India
with ANSWERS
Case 1
• 60 year male
• Upper GI discomfort for the past 7
months
• Underwent EGD - erosions in the
antrum
• Fundic and antral biopsies taken
Corpus Antrum
Ch. Inflammation Severe
Neutrophilic activity Moderate
H. pylori Severe
Intestinal metaplasiaMild
Atrophy
Case 1
Others:
Nil
Case 2
• 38 year male
• Pain in the epigastrium
• History of renal transplant and
immunosuppression
• Underwent EGD - irregular
erythematous areas in the body
• Fundic and antral biopsies taken
Corpus Antrum
Ch. InflammationMild
Neutrophilic activity
H. pylori
NilIntestinal metaplasia
Atrophy
Case 2
Others:
CMV Inclusions Present
Case 3
• 45 year female
• Unexplained megaloblastic anemia for
the past 5 months (Hb. 8 gms%)
• Underwent EGD - Gastric erosions,
more in the body with relative antral
sparing
• Fundic and antral biopsies taken
Corpus Antrum
Ch. Inflammation Mild
Nil
Neutrophilic activityNil
H. pylori
Intestinal metaplasia Moderate
Atrophy Marked
Case 3
Others:
Endocrine cell
hyperplasia
Pyloric metaplasia
Case 4
• 56 year female
• H/O malabsorbtion present 5 months.
Duodenal biopsy showed evidence of
celiac disease
• Now presented with dyspepsia
• Underwent EGD - Irregular nodularity
• Fundic and antral biopsies taken
Corpus Antrum
Ch. Inflammation
Nil
Severe
Neutrophilic activity
NilH. pylori
Intestinal metaplasia
Atrophy
Case 4
Others:
Increased theliolymphocytes
(40%)
Case 5
• 66 year female
• Now presented with heart burn - 4
months
• H/O Rheumatoid Arthritis +
• Underwent EGD - pre-pyloric mucosal
ulcerations
• Fundic and antral biopsies taken
Corpus Antrum
Ch. Inflammation
Nil
Neutrophilic activity
H. pylori
Intestinal metaplasia
Atrophy
Case 5
Others: 1. Villiform surface changes
2. Edema of lamina propria
3. Muscularis mucosa Hyperplasia with
ext. in to LP