1. The significance of focally enhanced gastritis in haematopoietic stem cell transplant recipients
- Author
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Jose Jessurun, Melanie Johncilla, and Sarah S Elsoukkary
- Subjects
Adult ,Male ,0301 basic medicine ,medicine.medical_specialty ,Histology ,medicine.medical_treatment ,Graft vs Host Disease ,Hematopoietic stem cell transplantation ,Gastroenterology ,Inflammatory bowel disease ,Pathology and Forensic Medicine ,03 medical and health sciences ,0302 clinical medicine ,immune system diseases ,Internal medicine ,Biopsy ,medicine ,Humans ,Aged ,Retrospective Studies ,Salivary gland ,medicine.diagnostic_test ,business.industry ,Hematopoietic Stem Cell Transplantation ,General Medicine ,Middle Aged ,medicine.disease ,Transplant Recipients ,Haematopoiesis ,surgical procedures, operative ,030104 developmental biology ,medicine.anatomical_structure ,Graft-versus-host disease ,Gastritis ,030220 oncology & carcinogenesis ,Female ,Stem cell ,medicine.symptom ,business - Abstract
AIMS The histological diagnosis of acute gastric graft-versus-host-disease (aGVHD) in patients with a history of haematopoietic stem cell transplant (HSCT) is based on the presence of epithelial cell apoptosis and karyorrhectic debris. There is, however, limited information on the histological findings in patients who develop symptoms several months after transplant. Focally enhanced gastritis (FEG), defined by the presence of focal periglandular lymphohistiocytic inflammation with neutrophilic or lymphocytic intra-epithelial infiltration of gastric glands, has been described in patients with inflammatory bowel disease and in HSCT patients. The pattern closely resembles the focal periductal inflammation and lymphocytic exocytosis seen in chronic GVHD of the salivary gland. We sought to evaluate the significance of FEG in HSCT patients. METHODS AND RESULTS Gastric biopsies from 151 HSCT patients who underwent endoscopies for GVHD-like symptoms were identified. Time from transplant to biopsy, presence of extra-gastric GVHD, medications and outcome were noted. Thirty-five biopsies showed FEG and 21 showed aGVHD; the remainder were either normal or showed non-specific changes. Twenty-one (60%) FEG patients had concurrent histologically proven extra-gastric GVHD. The time to biopsy in FEG patients was significantly longer than in aGVHD patients (162 versus 57 days, P
- Published
- 2021