Newton C, Nochomovitz L, Sackier J M
Department of Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC 20037, USA.
Ann Surg Oncol. 1998 Jul-Aug;5(5):407-10. doi: 10.1007/BF02303858.
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.
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.
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.
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.
肉芽肿性胃炎是一种罕见的病理诊断。这种情况在临床上常酷似胃腺癌，导致胃切除术。然而，肉芽肿性胃炎长期以来一直被视为一种良性病变，未观察到与胃腺癌相关。本文描述了一名肉芽肿性胃炎患者，其病变紧邻浅表浸润性胃腺癌区域。
进行了抗酸染色、真菌染色、标准培养、结核培养以及VDRL血清试验。同时进行了上消化道内镜检查和结肠镜检查。拍摄了胸部X光片并咨询了肺科专家。
切除的胃样本未显示异物反应迹象。抗酸染色、真菌染色、培养及VDRL检查均为阴性。内镜检查未在胃肠道其他部位发现肉芽肿性炎症。影像学或肺部检查未发现明显肺部疾病。
孤立性肉芽肿性胃炎是一种排除性诊断。该患者的检查结果不支持克罗恩病、结核病、结节病、梅毒、组织胞浆菌病、铍中毒或异物反应的诊断。这是一个独特的病例，提示孤立性肉芽肿性胃炎与化生黏膜改变之间可能存在关联。
