The clinical significance of focally enhanced gastritis.
Focally enhanced gastritis (FEG) is typified by small collections of lymphocytes and histiocytes surrounding a small group of foveolae or gastric glands, often with infiltrates of neutrophils. Several studies have found that FEG is commonly seen in Crohn's disease patients with a positive predictive value of 94%. Additional studies have found that FEG is present in up to 20% of pediatric ulcerative colitis patients, suggesting that FEG is a marker for inflammatory bowel disease (IBD) in general. We reviewed all gastric biopsies from a single calendar year (1999) to study the incidence of FEG and its relationship to IBD. A total of 34 cases of FEG were found among 971 gastric biopsies from 927 patients. Only 4 FEG patients were found to have IBD (2 Crohn's, 1 ulcerative colitis and 1 chronic colitis, type indeterminate, 11.8%, positive predictive value of 5.9%). Five FEG patients were status post bone marrow transplantation (14.7%). There were no other clinical correlations and gastric histopathology did not predict which patients with FEG had IBD. We conclude that FEG is not a common histologic finding in our patient population and that the positive predictive value of this finding is much too low to be thought of as a specific marker for IBD. An isolated biopsy diagnosis of FEG should not be interpreted as being suggestive of Crohn's disease.
Xin
Wei
W
Department of Pathology, University of Michigan Health System, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0054, USA.
Greenson
Joel K
JK
D000328:Adult; D000368:Aged; D001706:Biopsy; D016026:Bone Marrow Transplantation; D002648:Child; D003093:Colitis, Ulcerative / Q000150:complications / Q000453:epidemiology / Q000473:pathology; D003424:Crohn Disease / Q000150:complications / Q000453:epidemiology / Q000473:pathology; D005260:Female; D005756:Gastritis / Q000150:complications* / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000453:epidemiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013270:Stomach / Q000473:pathology