chronic active gastritis

Digital case

 HPC:311 : Follicular gastritis and active chronic gastritis, non-atrophical, Helicobacter pylori-associated

Definition: Chronic active gastritis is the inflammation of the stomach characterized by the simultaneous presence of a mononuclear cell infiltrate and neutrophilic polymorphonuclear inflammation.

Because this term may convey an entity (like chronic active hepatitis) rather than a phase of a single disease, it is preferable to use the term active as a descriptor, as in the original Sydney System (e.g., chronic gastritis, active).

Sydney system of grading

Feature	Definition	Grading Guidelines
Chronic inflammation	Increased lymphocytes and plasma cells in the lamina propria	Mild, moderate, or severe increase in density
Activity	Neutrophilic infiltrates of the lamina propria, pits, or surface epithelium	Less than one third of pits and surface infiltrated = mild; one third to two thirds = moderate; more than two thirds = severe
Atrophy	Loss of specialized glands from either antrum or corpus	Mild, moderate, or severe loss
Intestinal metaplasia	Intestinal metaplasia of the epithelium	Less than one third of mucosa involved = mild; one third to two thirds = moderate; more than two thirds = severe
Helicobacter pylori	H. pylori density	Scattered organisms covering less than one third of the surface = mild colonization; large clusters or a continuous layer over two thirds of surface = severe; intermediate numbers = moderate colonization

Microscopy

 The mucous neck regions appear hyperchromatic and are infiltrated with acute inflammatory cells.

Etiology

 Helicobacter pylori infection (Helicobacter pylori gastritis)
 Crohn gastritis (Crohn disease)
 immune deficiencies

• CVID-associated gastritis

Types

 focal active gastritis

See also

 gastric active inflammation (active gastritis)
 gastric acute inflammation (active gastritis)
 gastric inactive inflammation (inactive gastritis)