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A clinical, endoscopic and histological study was performed in 300 patients with chronic gastric erosions. The male-female ratio was 4:1. The antrum was the preferential site of erosions. Chronic erosions were classified into two categories: "active" (with a dark clot or whitish coat of fibrin) and "inactive" (covered by a normal pink mucosa). All the lesions showed foveolar hyperplasia, partial obliteration of the lamina propria by fibrous and smooth muscle bundles, a greatly thickened muscularis mucosae and an increased number of submucosal thick-walled vessels. In the "active" stage the central umbilicated area was covered by a collection of granulocytes, while in some of the "inactive" erosions the central depression showed the presence of a channel-like structure penetrating into the lamina propria. In two cases the lesion mimicked a gastric adenomyoma. Gastric acid secretion was significantly increased in the tested patients as compared with normal. The similarity of the histological findings with those in ischemic conditions of the gastro-intestinal tract suggests that both hypersecretion and localized ischemia may play a role in the pathogenesis of chronic erosions.

A case of adenocarcinoma occurring in a hyperplastic (metaplastic) polyp of the colon is presented. The polyp, two cm in diameter, was located in the transverse colon of a 45-year-old male patient, and was removed endoscopically. From the periphery to the centre, the polyp showed epithelial changes progressing from hyperplastic to severely dysplastic, terminating in a central focus of invasive adenocarcinoma. It is suggested that the considerable number of absorptive cells in large hyperplastic polyps may occasionally result in an excessive absorption of carcinogen thus leading to dysplastic changes.

Endoscopic examination of the upper gastrointestinal tract was performed in 12 patients after renal transplantation and immunosuppressive therapy. Histological examination of the specimens obtained from the duodenal bulb revealed the presence of cytomegalovirus (CMV)-type cells in four cases. In one of these patients several CMV-type cells were scattered in the duodenal mucosa and also affected the antral mucosa. In the other three cases just one or two cells with prominent intranuclear inclusions (CMV) were present in only a few of the multiple sections. No correlation of CMV inclusion with symptoms and with the morphological appearance of the upper gastrointestinal tract has been found. CMV infection seems to be correlated with immunosuppressive therapy.

Twenty cases of heterotopic fundic mucosa in the duodenum are reported. The patients had several small polyps ranging from one to three mm tightly grouped to form a plaque in a limited zone of the duodenal bulb. In some cases the polyps were separated from one another. They were round or conical and manifested a frosted-glass appearance with a pale-pink or redded coloration. In two cases a whitish solitary polyp of five mm was located in the 2nd part of the duodenum. Biopsies obtained from the polyps revealed them to be composed of fundal mucosa, thus representing a particular form of heterotopia, other then the steroid-induced type, and that of patients undergoing regular dialysis for uraemia. The different clinical and morphological data in the various forms of fundal heterotopia are discussed.