Gastric Biopsies: Increasing the Yield Marian M. Haber  Clinical Gastroenterology and Hepatology  Volume 5, Issue 2, Pages 160-165 (February 2007) DOI: 10.1016/j.cgh.2006.11.011 Copyright © 2007 AGA Institute Terms and Conditions

Figure 1 Superficial gastric antral biopsy with foveolar pits seen around the circumference of the tissue and only a few glandular lumina. There is mild foveolar hyperplasia. Note the fibrin thrombi (arrow) in the dilated vessel on the right side of the field with surrounding blood in the lamina propria. Clinical Gastroenterology and Hepatology 2007 5, 160-165DOI: (10.1016/j.cgh.2006.11.011) Copyright © 2007 AGA Institute Terms and Conditions

Figure 2 This gastric body biopsy shows no parietal or chief cells. There is insufflation artifact on the right side (filled arrowhead). A solitary gland shows intestinal metaplasia on the left side (yellow arrowhead). The remainder of glands are either pyloric or pseudopyloric type. There is focally endocrine linear cell hyperplasia in the lower left side of the field (asterisk) characterized by a double layer of cells lining the glands. Clinical Gastroenterology and Hepatology 2007 5, 160-165DOI: (10.1016/j.cgh.2006.11.011) Copyright © 2007 AGA Institute Terms and Conditions

Figure 3 The gastric body biopsy shows an increased gland to pit ratio. The parietal cells focally have a hobnail appearance, and the glands have mildly dilated lumina. This appearance might be due to any cause of hypergastrinemia, but it is most commonly a result of acid suppression therapy. Clinical Gastroenterology and Hepatology 2007 5, 160-165DOI: (10.1016/j.cgh.2006.11.011) Copyright © 2007 AGA Institute Terms and Conditions

Figure 4 Multiple mitotic figures with ring forms are seen in the proliferative region of the gastric pit. This patient had gout, and the findings are consistent with colchicine-related gastropathy. Clinical Gastroenterology and Hepatology 2007 5, 160-165DOI: (10.1016/j.cgh.2006.11.011) Copyright © 2007 AGA Institute Terms and Conditions

Figure 5 The low-power appearance of a round cell infiltrate in the lamina propria is characteristic of chronic gastritis. Active inflammation and Helicobacter pylori organisms were also identified. However, the deposition of extracellular material around the vessels at the base of the mucosa and within the muscularis mucosa was only identified as amyloid after the clinician informed the pathologist of a history of amyloid. This patient was subsequently diagnosed with a plasma cell myeloma. Clinical Gastroenterology and Hepatology 2007 5, 160-165DOI: (10.1016/j.cgh.2006.11.011) Copyright © 2007 AGA Institute Terms and Conditions

Figure 6 Adenocarcinoma characterized by neoplastic epithelium lining the pits and glands with new gland formation. Note the one non-neoplastic gland for contrast at the bottom of the field toward the middle (arrow). Clinical Gastroenterology and Hepatology 2007 5, 160-165DOI: (10.1016/j.cgh.2006.11.011) Copyright © 2007 AGA Institute Terms and Conditions