Collagenous Gastritis Presenting as Multiple Gastric Intramural Diverticulosis, Report of a Case Daisuke Yoshimura 1 , Kayoko Nakano 1 , Seiya Kato 2 , Yusuke Kitagawa 1 , Toshiaki Ochiai 1 , Tomohito Chaen 1 , Shinichiro Fukuda 1 , Nobuyoshi Takizawa 1 , Kaoru Ichida 1 , Souta Umetani 1 , Keiichi Midorikawa 3 1Division of Gastroenterology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan 2Division of Pathology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan 3Midorikawa Clinic, Fukuoka, Japan Keyword: collagenous gastritis , 胃多発壁内憩室症 , 狙撃生検 pp.1303-1312
Published Date 2020/9/25
DOI https://doi.org/10.11477/mf.1403202143
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 A 46-year-old asymptomatic man was referred to our hospital for further assessment of abnormal findings obtained from a barium X-ray of the stomach conducted during a health checkup. Gastroscopic examination revealed diffuse mucosal atrophy, which is more prominent in the gastric body than in the antrum. Moreover, multiple round or granular mucosal islands were scattered in the anterior or posterior wall of the gastric body. The surface of some round mucosal islands had shallow superficial depressions. Multiple deep depressions with small round or wedge-shaped orifices were also observed in the great curvature of the gastric body. Endoscopic ultrasonography revealed that these depressions were indicative of intraluminal diverticula. Biopsy revealed foveolar atrophy with chronic mucosal inflammation and a thickened eosinophilic band-like deposition beneath the epithelium, which yielded positive results for Azan staining and negative for Congo red or amyloid staining. These findings were consistent with those of collagenous gastritis. The biopsy results of another specimen collected from the edge of the round mucosal island of the gastric body did not reveal any remarkable findings, suggesting chronic inflammation inside the round mucosal islands. In contrast, the typical findings of collagenous gastritis, as described above, were found on the outer part of the round mucosa, indicating that collagenous gastritis causes diffuse, noncomparable, map-like mucosal inflammation and atrophy. In this case, multiple intramural diverticulosis progressed to collagenous gastritis.

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