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chronic active gastritis

Tuesday 18 October 2005

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


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


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

  • CVID-associated gastritis


- focal active gastritis

See also

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