Stomach Histology

Front 1

Name the 3 different types of mucosa in the stomach.

Back 1

Cardiac mucosa
Fundic mucosa
Pyloric mucosa (also antral)

Front 2

The histological changes between mucosa types in the stomach are (gradual/abrupt)

Back 2

Gradual (1-2 cm overlap) except for the Z line between esophagus and stomach.

Front 3

Identify the cells

Back 3

Front 4

Histologically, surface epithelium in the stomach is of ____ type cells with basally situated nuclei.

Back 4

Non ciliated simple columnar

Front 5

Histochemically, foveolar mucus is PAS (+/-) and Alcian blue (+/-)

Back 5

PAS+ and Alcian blue -

Front 6

Pure cardiac mucosa is generally found within ___mm from the most distal esophageal squamous mucosa.

Back 6

5mm

Front 7

Hybrid mucosa of the stomach consist of squamous cells underlying a columnar epithelium and may be a sign of

Back 7

Early Barrett's esophagus or metaplastic cardiac mucosa. Barrett's esophagus has a higher potential for malignant change.

Front 8

Fundic (oxyntic) gland mucosa, in contrast to cardiac and pyloric mucosa, have glands that are (tightly packed/loosely packed) and (straight/coiled).

Back 8

Tightly packed and straight

Front 9

What portion of the stomach is consistent with the histology?

Back 9

Cardiac and Pyloric mucosa

Front 10

Name the cells

Back 10

Front 11

Name the cell:

These cells are cuboidal with a basally situated nucleus, stain pale blue-gray and secrete pepsinogen

Back 11

Zymogenic cells (Chief cells)

Front 12

Name the cell

These cells are roughly triangular with their base along the basement membrane, with cytoplasm that usually stain pink and a central nuclei.

Back 12

Parietal cells

Front 13

Name the cell:

Difficult to recognize on an H&E stain, easily on PAS. Highly proliferative.

Back 13

Mucous cells

Front 14

Name the cell:

Simple non-ciliated columnar type cells that are replaced every 4-8 days.

Back 14

Surface epithelium

Front 15

In the antrum, endocrine cells include ___ which secrete gastrin and ___ cells which secrete histamine and ___ cells which secrete somatostatin.

Back 15

G cells, EC cells, D cells.

Front 16

In the fundic mucosa, a major portion of endocrine cells are ___ cells and produce histamine.

Back 16

ECF (enterochromaffin like cells)

(located at the base of glands)

Front 17

List four cell types found in the lamina propria of the stomach

Back 17

Fibroblasts, histiocytes, plasma cells, lymphocytes. (also occasional polymorphs and mast cells)

Front 18

Are lymphoid follicles found in the normal stomach?

Back 18

Yes, primary are but secondary lymphoid follicles with germinal centers are found only in gastritis (usually 2ndary to H Pylori)

Front 19

The muscular layer of the stomach consist of (how many) layers which are:

Back 19

3 layers:
Outer longitudinal, inner circular, and innermost oblique.

Front 20

PAS/Alcian blue stain will stain acid mucin (what color) and neutral acid (what color)

Back 20

Acid mucin is stained light blue, while neutral mucin is magenta. Combinations are purple.

Front 21

Some artifacts can be introduced during gastric sampling and include

Back 21

Crushing, stretching, biopsy induced hemorrhage.

Front 22

Early gastritis changes include

a) reduction in mucin content of the cytoplasm
b) increase in nuclear size
c) presence of one or more prominent nucleoli
d) increased mitosis at the base of the foveolae
d) all the above

Back 22

D

Front 23

T/F

In severe active H. pylori related inflammation, the epithelium and the lamina propria are infiltrated by acute inflammatory cells

Back 23

True

Front 24

Optimum recognition of H. Pylori is enhanced by using which stains?

Back 24

Giemsa, methylene blue, immunohistochemical stains.

Front 25

Chronic gastritis may present with which findings?

Back 25

Atrophy of the glands, increase in inflammatory cells in deep layers of the mucosa.

Front 26

A ___ stain can be used to visualize atrophic gastritis

Back 26

reticulin

Front 27

2 major types of metaplasia seen in the stomach are

Back 27

Intestinal metaplasia and Pyloric (pseudopyloric) metaplasia.

(neither are symptomatic)

Front 28

In pyloric metaplasia there is replacement of the ___ cells of the fundic glands with ____.

Back 28

a) specialized acid and enzyme secreting,

b) mucus secreting glands.

Front 29

Complete intestinal metaplasia is type (I/II) and consist of normal ___ epithelium, characterized by fully developed ___ cells and enterocytes with a brush border.

Back 29

a) small bowel
b) goblet

Front 30

T/F

Intestinal metaplasia reflects some degree of gastric damage usually from chronic gastritis.

Back 30

True