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Gastric ulcer
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Various images
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CT scan of the stomach
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Acute phlegmonous gastritis
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Acute phlegmonous gastritis
Diffusely hyperemic gastric mucosa
Areas of gastric hemorrhage depicting gastric erosions
Contributed by Supriya Srivastava, M.D., Ph.D. and Xiaoyan Liao, M.D., Ph.D.
Acute gastric erosion
Acute gastritis
Acute phlegmonous gastritis
Contributed by Cindy Wang, M.D.
Foveolar type adenoma
Intestinal type adenoma
Hybrid phenotype
Contributed by Leon Metlay, M.D.
22 week fetus with congenital diaphragmatic hernia
Liver and stomach in chest, heart shifted to right, both lungs small
Hypoplastic left lung and left heart
Hypoplastic right lung
Groove in liver, where diaphragm edge was
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Normal appearance of the stomach, opened along the greater curvature
Normal appearance of the gastric antrum extending to the pylorus at the right of center
Contributed by Kelsey E. McHugh, M.D.
Anatomic regions
Layers of gastric wall
Gastric mucosa
Contributed by Kelsey E. McHugh, M.D.
Gastric body with
unremarkable
rugal folds
Contributed by Leon Metlay, M.D. and Kelsey E. McHugh, M.D.
Anatomy:
Formalin fixed gastric body
Formalin fixed gastric rugal folds
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Anatomy:
Normal appearance of the stomach
Normal appearance of the gastric antrum
Total gastrectomy anatomic regions
Contributed by Kelsey E. McHugh, M.D.
Gastric wall layers
Oxyntic mucosa
Antral mucosa
Gastrin immunostain
Cardia mucosa
Parietal and chief cells
Gastric pits
Pseudo-signet ring cell artifact
Distended foveolar cells
PAS / AB in distended foveolar cells
Neuroendocrine cells in gastric antrum
Contributed by Kelsey E. McHugh, M.D.
Surface foveolar epithelium
Parietal cells
Chief cells
Contributed by Raul Gonzalez, M.D.
Gastric arteriovenous malformation
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Barium Xray
Contributed by Kirbylee Nelson, M.D.
Prominent submucosal vessels
Loss of rugal folds
Contributed by Jen Rytych, M.D. and Joshua A. Hanson, M.D.
Atrophic mucosa
Intestinal metaplasia
ECL cell hyperplasia
Atrophic mucosa and inflammation
Pseudopyloric metaplasia
Intestinal metaplasia
Positive H. pylori stain
Positive gastrin stain
Atrophic gastric body
Gastrin stain, body
Chromogranin stain, body
Antrum in autoimmune gastritis
Gastrin stain, antrum
Histology of atrophic gastritis
Histology of autoimmune atrophic gastritis
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Gastric tumor infiltrating the diaphragm
Contributed by Carolina Martinez Ciarpaglini, M.D., Ph.D.
Hemorrhagic gastric mass
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Ulcerated gastric mass
Early gastric cancer
Contributed by Clara Alfaro, M.D., Ph.D. and Carolina Martinez Ciarpaglini, M.D., Ph.D.
Mass in the gastric body
Linitis plastica
Serosal retraction
Giant distal gastric mass
Contributed by Carolina Martinez Ciarpaglini, M.D., Ph.D.
Gastric adenocarcinoma intestinal subtype
Diffuse adenocarcinoma
Poorly cohesive adenocarcinoma with signet ring cell phenotype
Contributed by Andrey Bychkov, M.D., Ph.D. and Jijgee Munkhdelger, M.D., Ph.D.
CMV gastritis ulcer
CMV gastritis IHC
CMV infected cells
Classic cytomegalic cell
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Duodenal biopsy
Contributed by Matthew Morrow, M.D.
Gastric nodularity
Gastric mucosa with mild nodularity
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Nodular gastric mucosa
Contributed by Matthew Morrow, M.D.
Increased subepithelial collagen with lamina propria chronic inflammation
Denudation of surface gastric epithelium
Thickened subepithelial collagen
Collagenous gastritis 100x
Abundant eosinophils 40x
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Thickened subepithelial collagen
Lamina propria inflammation
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Gastric and colonic polyps
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Gastric wall thickening, incomplete distention
Contributed by Gagandeep Kaur, M.D. and Monika Vyas, M.D.
Grossly no residual tumor
Negative for gross lesion
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Marked thickening of gastric wall with loss of rugae
Thickening of gastric wall
Contributed by Gagandeep Kaur, M.D. and Monika Vyas, M.D.
Diffuse gastric carcinoma associated with chronic gastritis
Signet ring cells
Peritoneal involvement
CK stain highlighting perineural invasion
Early diffuse gastric carcinoma
In situ carcinoma
Pagetoid spread of signet ring cell carcinoma
Contributed by Feng Yin, M.D., Ph.D.
Doxycycline associated mucosal injury
Eosinophilic capillary degenerative changes
Contributed by Kyra Berg, M.D.
Elongated and hyperchromatic nuclei
Elongated nuclei with visible nucleoli
Loss of polarity
Increased cellularity
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EUS, mucosal gastric cancer
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Endoscopy, type 0 lesions
Contributed by Guedj Nathalie, M.D., Ph.D.
Type 0-IIc
Contributed by Guedj Nathalie, M.D., Ph.D.
Gastric adenocarcinoma
Tubular adenocarcinoma
Cytologic and nuclear atypia
Angioinvasion
Early gastric carcinoma
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Endoscopy
Contributed by Iresha Vithanage, M.B.B.S., M.D. and Xiaoyan Liao, M.D., Ph.D.
Gastric mucosa with erosive gastritis
Surface erosion and inflammation
Acute erosive gastritis
Contributed by Kwun Wah Wen, M.D., Ph.D.
Dense lymphoplasmacytic infiltrate
Destruction of gastric glands
Focus of active inflammation
Marked plasmacytic differentiation
Lymphoepithelial lesion
Cytologic features of lymphoma cells
Diffusely positive for CD20
Numerous kappa restricted cells (κ:λ = > 8:1)
Rare lambda positive cells (κ:λ = > 8:1)
Low proliferative index
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t(11;18)(q21;q21) translocation
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Pedunculated lesion
Multiple polyps
Contributed by Naziheh Assarzadegan, M.D.
Cystically dilated glands
Fundic gland polyp with dysplasia
Case #389
Specialized gastric mucosa
Scattered dilated fundic type glands
Nuclear enlargement, hyperchromasia and stratification
Fundic gland polyp with dysplasia
Contributed by Tony El Jabbour, M.D.
Diffuse punctate pattern
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Striped pattern
Diffuse punctate pattern
Nodular pattern
Contributed by Hwajeong (Jenny) Lee, M.D.
Antrum with reactive changes
Fibrin thrombus
Histopathology of gastric antral vascular ectasia
Contributed by Carolina Martinez-Ciarpaglini, M.D., Ph.D.
Dense lymphoid infiltrate
Trabecular pattern
Tumor cells (high power)
Primitive tubular pattern
EBER expression
Cytokeratin expresion
T cell infiltrate (CD3)
Contributed by @RaulSGonzalezMD on Twitter
Gastritis cystica polyposa
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Elongated, tortuous
foveolae and hyperplastic
and cystically dilated
underlying pyloric gland
Contributed by Supriya Srivastava, M.D., Ph.D.
Updated Sydney protocol
OLGIM staging
Contributed by Supriya Srivastava, M.D., Ph.D.
Mild chronic gastritis
Moderate chronic gastritis
Marked chronic gastritis
Mild intestinal metaplasia
Moderate intestinal metaplasia
Marked intestinal metaplasia
Chronic active gastritis
H. pylori gastritis
Autoimmune gastritis
H. heilmanii gastritis
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CT and MRI with multilobulated cystic mass
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Lobulated stomach mass
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Solid and cystic mass
Variegated mass
Transmural mass
Contributed by Raul S. Gonzalez, M.D. and Rondell P. Graham, M.B.B.S.
Invasive tumor
Epithelial component
Nests of epithelioid cells
Spindle cell component
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Desmosomes and microvilli between tumor cells
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RT-PCR, MALAT1::GLI1 fusion and sequencing
GLI1 FISH
breakapart and
MALAT1::GLI1
fusion FISH
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Gastric GIST
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Endoscopy
Intraoperative mass
Gastroscopy
Contributed by Riki Turri, PA (ASCP)
Stomach GIST, cross section
Contributed by Phoenix D. Bell, M.S., M.D. and Jennifer Findeis-Hosey, M.D.
Spindle cell type
Stomach GIST (mixed type)
Evidence of mitotic activity
Prominent paranuclear vacuoles
Stomach GIST, epithelioid type
Stomach GIST, spindle cell type
Contributed by Andrey Bychkov, M.D., Ph.D.
Core biopsy
Core biopsy with IHC
CD34
C-kit / CD117
Contributed by Raul S. Gonzalez, M.D. (Case #523)
SDH deficient GIST
DOG1
SDHB
Contributed by Andrey Bychkov, M.D., Ph.D.
Highly cellular
Spindled
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c-kit mutations
Case #393
Contributed by @RaulSGonzalezMD on Twitter
Glomus tumor
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Epithelial cells (left), Calponin+ (right)
Solid growth pattern
Glomus cells and tumor
Contributed by Heidi D. Lehrke, D.O.
Grade 3 GVHD, glandular apoptosis and crypt drop out, several apoptotic figures seen in field
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Hepatic GVHD
Various images
Chronic graft versus host disease and the gastrointestinal tract
Contributed by Chungja C. Shim, M.D.
Gastric biopsy
Contributed by @liverwei and @DoktoraMalvar on Twitter
Helicobacter heilmannii
Helicobacter heilmannii
Contributed by Tanner Storozuk, M.D. and Namrata Setia, M.D.
Erosions
Ulcer
Nodular mucosa
Contributed by Tanner Storozuk, M.D. and Namrata Setia, M.D.
H. pylori in body
H. pylori in antrum
H. pylori in duodenum
Histology of H. pylori (left) versus H. heilmannii (right)
Immunostain for H. pylori
Stomach body H. pylori gastritis
Histopathology, H. pylori gastritis
Basic pathogenesis of H. pylori infection
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Total gastrectomy specimen
Contributed by Runjan Chetty, M.B.B.Ch., Ph.D. and Altaf Taher, M.B.B.S., M.D.
Signet ring carcinoma in situ
Loss of membranous E-cadherin staining
Contributed by Raul S. Gonzalez, M.D.
Signet ring carcinoma in situ
Obvious poorly cohesive carcinoma
Subtle poorly cohesive carcinoma
Contributed by Dennis J. Chute, M.D.
Heterotopic pancreas in annulus
Contributed by Dennis J. Chute, M.D.
Heterotopic exocrine pancreas in annulus
Contributed by Monica T. Garcia-Buitrago, M.D., Omar Aljuboori, M.B.B.S. and Andrey Bychkov, M.D., Ph.D.
Dilated gastric pits
Tortuous gastric pits
Edematous lamina propria
Pseudogoblet cells
Dysplasia
Dysplastic polyp
Dysplasia
Adenocarcinoma
Polypoid lesion
Hemorrhagic and ulcerated
Cystic hyperplastic glands
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Focal lesion in
atral mucosa
resembling active
Crohn's disease
Contributed by Raul S. Gonzalez, M.D.
Small polypectomy
Contributed by Naziheh Assarzadegan, M.D.
Submucosal mass
Spindle and stellate stromal cells
Eosinophils
Case #421
Polypoid mass expanding the submucosa
Mixed inflammatory infiltrate in fibromyxoid stroma, rich in eosinophils
Loose, fibromyxoid spindled stroma
CD34+ stromal cells with onion skinning
Stroma is CD117-,
with scattered
CD117+ mast cells
Contributed by Supriya Srivastava, M.D., Ph.D.
Correa pathway
Updated Sydney protocol
OLGA / OLGIM staging
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High resolution white light endoscopy
Whitish mucosal patches
Contributed by Supriya Srivastava, M.D., Ph.D.
Goblet cells and H. pylori
Intestinal metaplasia grading
PAS / Alcian blue and HID / Alcian blue
MUC2
CDX2
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Areas of intestinal metaplasia of the stomach
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Ulcerating mass and lymphadenopathy
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Gastric cancer at endoscopy
Contributed by @Andrew_Fltv on Twitter
Contributed by @Andrew_Fltv on Twitter (see original post here)">
Intestinal type adenocarcinoma
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Gastric cancer resection specimen
Contributed by Adrian C. Bateman, M.B.B.S., M.D.
Tubular adenocarcinoma
Tumor regression
HER2
PDL1
Contributed by @Andrew_Fltv on Twitter
Contributed by @Andrew_Fltv on Twitter (see original post here)">
Intestinal type adenocarcinoma
Contributed by Monica Garcia-Buitrago, M.D.
Gastric mucosa
Contributed by Monica Garcia-Buitrago, M.D. and Domenika Ortiz, M.D.
Brown crystalline iron deposition
Prussian blue stain
Mucosal calcinosis
Mucosal calcinosis von Kossa stain
Nonspecific pill gastritis
Contributed by Ashwini Kumar Esnakula, M.D., M.S.
Endoscopy
Contributed by Ashwini Kumar Esnakula, M.D., M.S.
Multiple polyps
Contributed by Ashwini Kumar Esnakula, M.D., M.S.
Classic juvenile polyp
Epithelial dominant variant
Dilated crypts
Inflamed stroma
Low grade dysplasia
High grade dysplasia
Case #442
Lanthanum carbonate in stomach
Von Kossa
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Large gastric leiomyosarcoma (> 8 cm)
Contributed by Raul S. Gonzalez, M.D.
Leiomyosarcoma
Case #438
H&E
SMA
MSA
Desmin
Ki67
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Varioliform gastritis:
multiple nodules with
central mucosal
atrophy / erosion
Contributed by Matthew Morrow, M.D.
Increased intraepithelial lymphocytes
Increased intraepithelial lymphocytes, expanded lamina propria
Biopsy from area of nodular gastric mucosa
Contributed by @RaulSGonzalezMD on Twitter
Contributed by @RaulSGonzalezMD on Twitter (see original post here)">
Lymphocytic gastritis
Contributed by Matteo Fassan, M.D., Ph.D.
HER2 3+ positive gastric adenocarcinoma
EBER positive gastric adenocarcinoma
MLH1 negative gastric adenocarcinoma
Contributed by Robin Pike, M.D.
Granular material in lamina propria
Positive von Kossa stain
Contributed by Natalia Liu, M.D. and Hanlin L. Wang, M.D., Ph.D.
Flat raised nodule
Contributed by Natalia Liu, M.D. and Hanlin L. Wang, M.D., Ph.D.
Low power architecture
Irregular glands
Predominantly chief cell differentiation
Contributed by @liverwei on Twitter
Oxyntic gland polyp
Oxyntic gland polyp
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Various images
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Gastric Peutz-Jeghers polyps
Contributed by Yujun Gan, M.D., Ph.D. and Xiuli Liu, M.D., Ph.D.
Large gastric antral mass
Large mural hypoechoic mass
FNA of the mass
Contributed by Yujun Gan, M.D., Ph.D. and Xiuli Liu, M.D., Ph.D.
Antral mass
Myxoid and cystic degeneration
Contributed by Yujun Gan, M.D., Ph.D. and Xiuli Liu, M.D., Ph.D.
Hypocellular and myxoid tumor
Bland spindle cell proliferation
Fibrillary stroma
Spindle and myxoid tumor
Smooth muscle actin immunoreactivity
Contributed by Raul S. Gonzalez, M.D.
Plexiform architecture
Bland myxoid tumor
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Small, round
lymphocyte-like
cells with hyper-
chromatic nuclei
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Gastric serpentine mucosal folds
Contributed by Michael Schoech, M.D.
Endoscopy: mosaic-like pattern
Contributed by Divya Sharma, M.D.
Congestion and reactive gastropathy
Congested blood vessels
Lamina propria fibrosis
Ectatic blood vessels
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Changes in normal oxyntic mucosa on chronic PPI use
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PPI related gastric mucosal changes
Black spots in the gastric mucosa
Contributed by Saadiya Nazli, M.D., Catherine E. Hagen, M.D. and Roger Moreira, M.D.
Parietal cell hyperplasia
Histological changes with PPI use
Cytoplasmic vacuolization; parietal cells
Fundic gland polyps
Cystic dilation of glands versus normal mucosa
Sleeve gastrectomy specimen
Contributed by Supriya Srivastava M.D., Ph.D.
Endoscopic appearance
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Endoscopy
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Intraoperative image
Contributed by Supriya Srivastava M.D., Ph.D.
Antral polyp
PGA without dysplasia
MUC5AC staining
MUC6 staining
MUC2 staining
PGA with dysplasia
High grade dysplasia
Low grade dysplasia
PGA with and without dysplasia
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Thickened muscularis propria
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Bile with erythematous mucosa
Erythema / edema
after choledocho-
duodeno
anastomosis
Contributed by Aaron R. Huber, D.O.
Reactive epithelium
Epithelial injury without inflammation
Gastritis versus gastropathy
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Large, irregular and deep
ulcerated mass lesion
with central ulceration
at the incisura angularis
Case #410
H&E
Positive for CD138 stain
Contributed by @RaulSGonzalezMD on Twitter and Cases #455 and #347
Schwannoma
Microcystic variant of schwannoma in stomach
S100, microcystic variant
CD117, microcystic variant
46 year old woman
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Polyps and atrophic gastritis
Contributed by Dana Razzano, M.D. and @RaulSGonzalezMD on Twitter
Nests of neuroendocrine tumor cells
Chromogranin stain
Well differentiated neuroendocrine tumor
Well differentiated neuroendocrine tumor
Neuroendocrine nuttiness in the digestive system - Dr. Raul S. Gonzalez
GI neuroendocrine tumors classification - Dr. Vikram Deshpande
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Endoscopic yellow plaque-like lesion
Endoscopic yellow nodule and plaque-like lesion
Contributed by Aaron R. Huber, D.O.
Foamy macrophages within the lamina propria
CD68
Arnold: 2019
IARC: 2019
Lamps: 2015
Lauwers: 2021
Montgomery: 2024
Montgomery: 2018
Noffsinger: 2017
Odze: 2022
Srivastava: 2023
Voltaggio: 2024
Yantiss: 2021
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