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idiopathic granulomatous gastritis

Sunday 4 March 2012

The diagnosis of idiopathic granulomatous gastritis is made when other entities associated with granuloma formation have been excluded.

Symptomatic patients usually present over the age of 40 with epigastric pain, bleeding, weight loss, and vomiting secondary to pyloric obstruction.

The histologic changes parallel those seen in sarcoid disease, so that a definitive morphologic diagnosis may be impossible.

The predominant findings consist of antral narrowing and rigidity caused by trans-mural, noncaseating granulomas.

The inflammation and fibrosis rarely extend beyond the mucosa.

Ulcers similar to peptic ulcers may develop, but the slit-shaped ulcers and fissures typical of Crohn disease are absent.

In a third of cases, regional lymph nodes become involved.

Controversy exists asto whether idiopathic granulomatous gastritis represents a distinctive entity or whether it represents an isolated or limitedform of gastric sarcoid or Crohn disease.

In the United States, most patients with gastric granulomas will eventually be shown to have inflammatory bowel disease (IBD) or sarcoid disease. The latter diagnoses may become evident over time.

See also

- granulomatous gastritis