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xanthogranulomatous gastritis

Sunday 18 March 2012

Differential diagnosis

A diagnosis of idiopathic granulomatous gastritis is made when non-caseating granulomas are seen and Crohn’s disease and sarcoidosis have been excluded.

Barium granuloma, a rare complication of x ray examination, shows collections of macrophages and multinucleated giant cells filled with granular material.

Hyalinoid giant cell gastritis is characterised by eosinophilic hyalinoid degeneration of smooth muscle which elicits a giant cell
granulomatous reaction.

However, in all the aforementioned conditions, a prominent foamy cell infiltrate, as seen in the present case, is not observed.

Malacoplakia is characterised by accumulations of macrophages with granular, acidophilic cytoplasm containing laminated structures called Michaelis-Gutmann bodies. Although malacoplakia and xanthogranulomatous processes are morphologically and perhaps pathogenetically similar, accounting for the existence of transitional forms, Michaelis-Gutmann bodies are found only in malacoplakia.

Inflammatory pseudotumour or plasma cell granuloma may be present
as a mass in many sites, including the stomach, and shows a variable admixture of plasma cells, spindle cells of myofibroblastic type, and
foamy histiocytes. Thus the histological picture may be very suggestive of a xanthogranulomatous process.

See also

- xanthogranulomatous inflammation

References

- Xanthogranulomatous gastritis: Associatlion with xanthogranulomatous cholecystitis M Guarino, D Reale, G Micoli, P Tricomi, E Cristofori. J Clin Pathol 1993;46:88-90 Link

- Xanthogranulomatous gastritis: association with xanthogranulomatous cholecystitis. Guarino M, Reale D, Micoli G, Tricomi P, Cristofori E. J Clin Pathol. 1993 Jan;46(1):88-90. PMID: #8432899#