Gastric adenocarcinoma associated with isolated granulomatous gastritis.
BACKGROUND
Granulomatous gastritis is a rarely observed pathological diagnosis. This condition often mimics gastric adenocarcinoma clinically, resulting in gastric resection. However, granulomatous gastritis has long been viewed as a benign process not observed in association with adenocarcinoma of the stomach. This article describes a patient with granulomatous gastritis occurring in close proximity to an area of superficially invading gastric adenocarcinoma.


METHODS
Acid-fast stains, fungal stains, standard cultures, tuberculosis cultures, and a VDRL serum test were all obtained. Both upper endoscopy and colonoscopy were performed. Chest radiographs were taken and pulmonary consultation was obtained.


RESULTS
The gastric samples obtained from resection showed no evidence of foreign body reaction. The acid-fast stains, fungal stains, cultures, and VDRL were all negative. Endoscopic exams did not show granulomatous inflammation in any other part of the gastrointestinal tract. No pulmonary disease was evident on radiographic or pulmonary exam.


CONCLUSIONS
Isolated granulomatous gastritis is a diagnosis of exclusion. The findings in this patient do not support a diagnosis of Crohn's disease, tuberculosis, sarcoidosis, syphilis, histoplasmosis, berylliosis, or foreign-body reaction. This is a unique case suggesting an association between isolated granulomatous gastritis and metaplastic mucosal changes.
Newton
C
C
Department of Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC 20037, USA.
Nochomovitz
L
L
Sackier
J M
JM
D000230:Adenocarcinoma / Q000473:pathology*; D015897:Comorbidity; D003937:Diagnosis, Differential; D005753:Gastric Mucosa / Q000473:pathology; D005758:Gastritis, Hypertrophic / Q000175:diagnosis / Q000473:pathology*; D006099:Granuloma / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000473:pathology*