Rubio C A, Ost A, Kato Y, Yanagisawa A, Rivera F, Hirota T
Department of Pathology, Karolinska Institute and Hospital, Stockhom, Sweden.
APMIS. 1997 Oct;105(10):784-92. doi: 10.1111/j.1699-0463.1997.tb05084.x.
Thirteen gastrectomy specimens having diffuse (n = 5), focal (i.e., nodular, n = 6) or combined (n = 2) giant hypertrophic folds at gross examination were reviewed. Of the five specimens with grossly diffuse hypertrophic fundic mucosal folds, two had at histology tortuous foveolar hyperplasia (without intraepithelial lymphocytosis) and prominent glandular cysts; they were classified as Ménétrier's gastropathy. The other three specimens with diffuse foveolar hyperplasia had serrated foveolar infoldings with marked intraepithelial lymphocytosis; they were classified as Ménétrier-like lymphocytic gastritis. Of the six, specimens with multiple mucosal nodules at gross examination, four had focal foveolar hyperplasia with crest depression and no intraepithelial lymphocytosis; they were classified as varioliform gastropathy. The other two specimens with multiple nodules at gross examination had focal foveolar hyperplasia with marked intraepithelial lymphocytosis; they were classified as varioliform gastritis. In the remaining two cases, both diffuse and nodular hypertrophic gastric mucosa were found at gross examination; at histology, both foveolar hyperplasia and intraepithelial lymphocytosis were found. The diffuse or focal distribution of the lesions, the occurrence of intraepithelial lymphocytosis and the architecture of the upper part of the crypts (in diffuse foveolar hyperplasias) were valuable criteria in the differential diagnosis between the various types of foveolar hyperplasia of the stomach.
对13例胃切除标本进行了回顾性研究，这些标本在大体检查时具有弥漫性（n = 5）、局灶性（即结节性，n = 6）或合并性（n = 2）巨大肥厚性皱襞。在5例大体上有弥漫性肥厚性胃底黏膜皱襞的标本中，2例在组织学上表现为迂曲的小凹增生（无上皮内淋巴细胞增多）和显著的腺囊肿；它们被归类为门脉性胃病。另外3例有弥漫性小凹增生的标本有锯齿状小凹内褶，伴有明显的上皮内淋巴细胞增多；它们被归类为门脉样淋巴细胞性胃炎。在6例大体检查有多个黏膜结节的标本中，4例有局灶性小凹增生，伴有嵴凹陷且无上皮内淋巴细胞增多；它们被归类为痘疮样胃病。另外2例大体检查有多个结节的标本有局灶性小凹增生，伴有明显的上皮内淋巴细胞增多；它们被归类为痘疮样胃炎。在其余2例中，大体检查发现既有弥漫性又有结节性肥厚性胃黏膜；在组织学上，既有小凹增生又有上皮内淋巴细胞增多。病变的弥漫性或局灶性分布、上皮内淋巴细胞增多的出现以及隐窝上部的结构（在弥漫性小凹增生中）是胃不同类型小凹增生鉴别诊断中有价值的标准。
