🩺 STOMACH PATHOLOGY — ONE-LINERS
NEET PG • FMGE • INI-CET RAPID REVISION
Stomach Lesions • Exam Buzzwords
H. pylori gastritis = Curved bacilli, urease positive, chronic active gastritis
Autoimmune (Type A) gastritis = Parietal cell antibodies, intrinsic factor deficiency, B12 deficiency
Menetrier disease = Giant rugal folds, protein-losing gastropathy, ↑ TGF-α
Zollinger–Ellison syndrome = Gastrinoma (duodenum/pancreas), ↑ gastrin, multiple ulcers
Gastric ulcer = NSAIDs, H. pylori, stress; clean-based, incisura angularis common
Duodenal ulcer = Gastrin excess (ZES), H. pylori; anterior wall, near pylorus
Stress (acute) ulcers = Curling (burns), Cushing (head injury), multiple superficial ulcers
Hypertrophic pyloric stenosis = Infants, projectile vomiting, ↓ pyloric canal, olive mass
Peptic stricture = Healing of chronic ulcers → fibrosis and luminal narrowing
MALT lymphoma = H. pylori associated, low-grade B-cell lymphoma
Diffuse large B-cell lymphoma = Most common aggressive gastric lymphoma
Lauren classification = Intestinal type (gland-forming) > Diffuse type (signet ring cells)
Intestinal type adenocarcinoma = Atrophic gastritis → intestinal metaplasia → dysplasia
Diffuse type adenocarcinoma = E-cadherin (CDH1) loss, linitis plastica
Signet ring cell carcinoma = Mucin pushing nucleus to periphery, diffuse type
Hereditary diffuse gastric cancer = CDH1 mutation, lobular breast cancer association
Familial adenomatous polyposis = Fundic gland polyps, duodenal adenomas
Gastric polyps – Fundic gland = Associated with FAP, usually multiple
Gastric polyps – Hyperplastic = Chronic gastritis, H. pylori, bleeding common
Gastric polyps – Adenomatous = Premalignant, intestinal type metaplasia
Menetrier vs Ménétrier mimic (ZES) = Menetrier (↓ acid), ZES (↑ acid)
CMV gastritis = Large cells with “owl’s eye” intranuclear inclusions
Portal hypertensive gastropathy = Mosaic snake-skin pattern in mucosa
Erosive gastritis = NSAIDs, alcohol, bile reflux; superficial erosions
Atrophic gastritis = Loss of glands, intestinal metaplasia, ↑ risk of carcinoma
Intestinal metaplasia = Goblet cells in gastric mucosa, precancerous lesion
Dysplasia in stomach = Low-grade → architectural distortion; High-grade → carcinoma in situ
Carcinoid tumor = ECL cell hyperplasia, MEN1 association
GIST (stomach) = c-KIT (CD117) positive, most common mesenchymal tumor
Pernicious anemia = IF deficiency → B12 deficiency → macrocytic anemia
Clinical Pearls
Gastric ulcer → Pain after food
Duodenal ulcer → Pain relieved by food / antacids
Atrophic gastritis → High risk of adenocarcinoma
Menetrier → Protein loss (edema, hypoalbuminemia)
Pernicious anemia → B12 deficiency
Mnemonic — Gastric Polyps
F – H – A
F = Fundic gland → FAP
H = Hyperplastic → H. pylori
A = Adenomatous → Premalignant
High-Yield Summary
H. pylori → Gastritis, Ulcer, MALT lymphoma, Adenocarcinoma
ZES → ↑ Gastrin → Multiple ulcers
CDH1 mutation → Diffuse type adenocarcinoma
Intestinal metaplasia → Precancerous
Pernicious anemia → IF deficiency → B12 deficiency
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