PANCREATIC METAPLASIA OF GASTRIC MUCOSA ASSOCIATED WITH ACUTE EROSIVE GASTRITIS

Abstract

We describe the case of a female patient aged 75, whose biopsy material was received in the Department of Pathology of Tbilisi State Medical University, with diagnose of acute erosive gastritis, defined by endoscopic examination.  For the histopathology study we harvested gastric wall fragments (cardial area) from the lesion site. In the histopathology exam of the gastric wall at erosion area in the mucosal chorion (Lamina propria) we found numerous round or oval shaped nested formations, with diameters between 150 and 350 microns, which were separated by variable amounts of lax conjunctive tissue with rare vascular vessels, conjunctive fibers and cells. The acinar formations were formed by pyramid or pyramid body shaped cells with slight basophilic cytoplasm, fine granules, with round basophilic nuclei frequently found in the basal region, with distinct nucleoli and eosinophilic cytoplasm. Cells were delimited by a thin basal membrane which continued with the basal membrane of the gastric glands. Acinar cells have delimited a small round or star shaped lumen at their apical pole. We also found hypertrophic mucosa with a rich chronic inflammatory infiltrate containing lymphocyte and plasmocyte cells in the chorion (lamina propria) and local fibrosis. Thus, the diagnose was Pancreatic acinar cell metaplasia related with acute erosive gastritis.  The objective of description of this rare morphologic diagnose is Pancreatic metaplasia of gastric mucosa that can be localized at a cardiac level and can be associated with gastric erosion.  From clinical point of view, differential diagnosis of this pathology to ectopic pancreas is important for purpose of definition of its oncologic potential and methods of further treatment.