Gastritis – The cytological diagnosis of diseases of the alimentary canal

Gastritis is the most common disease of the stomach. In acute gastritis in native cytology specimens can reveal a significant amount of mucus, white blood cells in the mucous scraps, cell gastric epithelial, who are often subjected to vacuolation and fatty degeneration, located mainly in the form of layers and snapshots from the glands. This cytological picture is a superficial catarrhal gastritis. Cytological examination of stomach contents is particularly informative when normatsidnom gastritis.

With the development of inflammatory hyperemia there are small hemorrhages and erosion. Microscopic examination reveals gastric mucous bloody shreds, containing white blood cells and epithelial cells with signs of vacuolization and fatty degeneration. Specific in this is the presence of mucous scraps of red blood cells at a reduced acidity or diffuse blood pigment (hemosiderin) - At elevated.

By precancerous diseases include:

• chronic gastritis;
• peptic ulcer;
• gastric polyposis.

Chronic gastritis - A common disease, of 50 60 % Pathology of the stomach. Of greatest interest is chronic gastritis with atrophy and outcome in polypoid, adenomatous, cystic, erosive or ulcerative.

The combination of regenerative, hyperplastic, atrophic, fibrotic and ulcerative processes causes variegated morphological picture of gastritis. The most common atrophic gastritis with impaired structure of the surface epithelium and the epithelium of the gastric glands. These changes are accompanied by some atypia cells of the gastric mucosa.

Sometimes along with hypochlorhydria observed atrophic-hyperplastic gastritis, when the background of mucosal atrophy detected plots proliferating epithelial. In cytological preparations of proliferating cells arranged in a papillary structures and zhelezistopodobnyh, as well as layers and clusters. These cells are large-sized and medium-sized, with large nuclei and coarse chromatin structure. There is moderate cellular and nuclear polymorphism. There are figures of mitosis.

In cases sharply marked proliferation of the columnar epithelium characterized by the presence in the preparation of large polymorphic cells (30-35 microns), ranging disordered clusters. The nuclei of large, irregular shape, with irregular contours, It contains coarse chromatin structure and hypertrophied nucleoli. The nuclear-cytoplasmic ratio is changed by increasing cores. There mitotic figures. With such a cytological picture is necessary to eliminate the cancer dynamic cytological and histological observation. From proliferating areas often develop stomach cancer.

In other cases, gastritis with impaired epithelial structure, intestinal metaplasia occurs by type. Microscopic examination of the mucus found in greater or lesser amount of white blood cells. Epithelial cells of the stomach part vacuolated, with symptoms of intestinal metaplasia. Thus they become larger, elongated. The nuclei of oval or round, hyperchromatic, arranged eccentrically. The cytoplasm of the cells in the apical part of the wider, inhomogeneous, abundant vacuolated, in individual cells contain edges, napomynayuschuyu cuticle. Can see goblet cells. Described gut epithelial cells resemble epithelium. Some cells with signs of intestinal metaplasia may have a core of young, containing delicate chromatin pattern and small nucleoli. Such cells are located mainly in the form of clusters and layers.

Gastritis may occur in the mucosa of the small warty formations, sometimes rejected, acquiring a kind of bloody scraps plotnovata. Microscopic examination of such entities are the basis of a typical lymphoid glands in the stomach. Swollen epithelial cells, some increased, with enlarged nuclei, in the cytoplasm of the phenomena of vacuolization and fatty degeneration. Identified Education indicate hypertrophic process.

In atrophic gastritis mucosal changes are accompanied by a decrease in the number and shortening glands, which leads to a reduction in the amount of epithelial cells and reduce or eliminate the production of mucus.

If you rarely meet phlegmonous gastritis stomach contents is usually not recovered, in the vomit on microscopic examination revealed a large number of white blood cells.

When fibrous gastritis in preparations can be identified brownish-grayish, covered with bacteria, necrotic particles with the collapse of hemosiderin.