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Small bowel (small intestine)

Congenital anomalies

Heterotopic gastric mucosa

Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 8 January 2016, last major update August 2012
Copyright: (c) 2003-2016, PathologyOutlines.com, Inc.


● Mature gastric tissue in location where normally not found (i.e. small bowel)
● Discrete small nodules or sessile polyps, usually in duodenum (first and second part)
● May cause obstruction, diarrhea, ulceration, bleeding, perforation, intussusception, pain (Pediatr Dev Pathol 2000;3:277)

Case reports

● 50 year old man with duodenal polyp (Case of the Week #124)
● 52 year old woman with jejunal mass (Arch Pathol Lab Med 2003;127:506)
● 67 year old woman with gastric type adenoma (Virchows Arch 1999;435:452)

Gross images

Case of the Week #124

Figure 1

Micro description

● Mature gastric tissue, usually fundic type mucosa with chief and parietal cells, lined by foveolar epithelium, with a full mucosal thickness, forming a mucosal island
● Divided into two subtypes, one lined by foveolar epithelium only (congenital or acquired) and another foveolar epithelium along with fundic glands (congenital only) (Int J Clin Exp Pathol 2012;5:46)
● Gastric metaplasia in the duodenum is associated with H. pylori infection and is probably not congenital (Hum Pathol 2003;34:156)

Micro images

Case of the Week #124

Various images

Differential diagnosis

● Gastric metaplasia: associated with chronic inflammation, duodenitis and H. pylori, only occupies part of mucosal thickness, typically no gross findings, no parietal cells (Braz J Med Biol Res 2007;40:897, Dig Liver Dis 2002;34:16)
Peptic ulcer disease: no goblet cells

End of Small bowel (small intestine) > Congenital anomalies > Heterotopic gastric mucosa

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