J Korean Med Sci.  2005 Feb;20(1):146-149. 10.3346/jkms.2005.20.1.146.

Collagenous Gastritis in A Korean Child: A Case Report

Affiliations
  • 1Department of Pathology, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea. ylsuh@smc.samsung.co.kr
  • 2Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.

Abstract

Collagenous gastritis, a counterpart of collagenous colitis, is an extremely rare disorder. The first case of collagenous gastritis in a Korean boy in his preteens who had been receiving treatment for refractory iron deficiency anemia has been reported. The patient had been suffering from intermittent abdominal pain, recurrent bloodtinged vomiting and poor oral intake. The gastric endoscopy revealed diffuse cobblestone appearance of the mucosa with easy touch bleeding throughout the stomach but no abnormalities in the esophagus, duodenum, and colon. Pathologic examination of the gastric biopsies from the antrum, body and cardia showed a subepithelial collagen deposition with entrapped dilated capillaries, moderate infiltrates of lymphoplasma cells and eosinophils of the lamina propria, and marked hypertrophy of the muscularis mucosa. The collagen deposition appeared as discontinuous bands with focally irregular extension into the deeper part of the antral mucosa. It measured up to 150 micrometer. Helicobacter pylori infection was not detected. The biopsies from the duodenum, esophagus and colon revealed no pathologic abnormalities.

Keyword

Gastritis; Gastritis, Collagenous; Child; Endoscopy

MeSH Terms

Biopsy
Child
Colitis/*diagnosis/pathology
Collagen/metabolism
Endoscopy
Gastric Mucosa/pathology
Gastritis/pathology
Gastrointestinal Hemorrhage/diagnosis/pathology
Helicobacter pylori/metabolism
Humans
Korea
Male
Mucous Membrane/pathology
Stomach Diseases/diagnosis/pathology

Figure

  • Fig. 1 Endoscopy of the stomach shows polypoid mucosal nodules around the pyloric ring.

  • Fig. 2 Endoscopic biopsy from the antral mucosa shows subepithelial collagenous deposition, slough of surface epithelium, inflammatory cell infiltration, and hypertrophy of muscularis mucosa (H&E, ×100).

  • Fig. 3 High power magnification of Fig. 2. The subepithelial collagenous bands contains entrapped dilated capillaries and inflammatory cells (H&E, ×200).


Cited by  1 articles

Two Cases of Pediatric Collagenous Gastritis Each Presenting with Refractory Iron Deficiency Anemia and Chronic Diarrhea
Yeoun Joo Lee, Kyung Mo Kim, Seok Hee Oh, Seung Min Song, Eunsil Yu, Kyung Nam Koh
Pediatr Gastroenterol Hepatol Nutr. 2012;15(3):183-187.    doi: 10.5223/pghn.2012.15.3.183.


Reference

1. Lagorce-Pages C, Fabiani B, Bouvier R, Scoazec JY, Durand L, Flejou JF. Collagenous gastritis: a report of six cases. Am J Surg Pathol. 2001. 25:1174–1179.
2. Colletti RB, Trainer TD. Collagenous gastritis. Gastroenterology. 1989. 97:1552–1555.
Article
3. Stancu M, De Petris G, Palumbo TP, Lev R. Collagenous gastritis associated with lymphocytic gastritis and celiac disease. Arch Pathol Lab Med. 2001. 125:1579–1584.
Article
4. Vesoulis Z, Lozanski G, Ravichandran P, Esber E. Collagenous gastritis: a case report, morphologic evaluation, and review. Mod Pathol. 2000. 13:591–596.
Article
5. Côté JF, Hankard GF, Fauré C, Mougenot JF, Holvoet L, Cezard JP, Navarro J, Peuchmaur M. Collagenous gastritis revealed by severe anemia in a child. Hum Pathol. 1998. 29:883–886.
Article
6. Castellano VM, Munoz MT, Colina F, Nevado M, Casis B, Solis-Herruzo JA. Collagenous gastrobulbitis and collagenous colitis: case report and review of the literature. Scand J Gastroenterol. 1999. 34:632–638.
7. Pulimood AB, Ramakrishna BS, Mathan MM. Collagenous gastritis and collagenous colitis: a report with sequential histological and ultrastructural findings. Gut. 1999. 44:881–885.
Article
8. Stolte M, Ritter M, Borchard F, Koch-Scherrer G. Collagenous gastroduodenitis on collagenous colitis. Endoscopy. 1990. 22:186–187.
Article
9. Groisman GM, Meyers S, Harpaz N. Collagenous gastritis associated with lymphocytic colitis. J Clin Gastroenterol. 1996. 22:134–137.
Article
10. Borchard F, Niederau C. Collagenous gastroduodenitis. Dtsch Med Wschr. 1989. 114:1345.
11. Kajino Y, Kushima R, Koyama S, Fujiyama Y, Okabe H. Collagenous gastritis in a young Japanese woman. Pathol Int. 2003. 53:174–178.
Article
12. Jawhary AJ, Talbot IC. Microscopic lymphocytic and collagenous colitis. Histopathology. 1996. 29:101–110.
Article
13. Teglbjaerg PS, Thaysen EH, Jansen HH. Development of collagenous colitis in sequential biopsy specimens. Gastroenterology. 1984. 87:703–709.
Article
14. Jessurun J, Yardley JH, Lee EL, Vendrell DD, Schiller LR, Fordtran JS. Different names for the same condition? Gastroenterology. 1986. 91:1583–1584.
15. Rams H, Rogers AI, Ghandur-Mnaymneh L. Collagenous colitis. Ann Intern Med. 1987. 106:108–113.
Article
16. Lawson JM, Wolosin J, Mottet MD, Brower RA. Collagenous colitis: an association with fecal leukocytes. J Clin Gastroenterol. 1988. 10:672–675.
17. Jawhari A, Talbot IC. Microscopic, lymphocytic and collagenous colitis. Histopathology. 1996. 29:101–110.
Article
18. Widgren S, Jlidi R, Cox JN. Collagenous colitis: histologic, morphometric immunohistochemical and ultrastructural studies. Report of 21 cases. Virchow Arch A Pathol Anat Histopathol. 1988. 413:287–296.
Article
19. Kingham JG, Levison DA, Morson BC, Dawson AM. Collagenous colitis. Gut. 1986. 27:570–577.
Article
20. Colina F, Solis-Herruzo JA, Munoz-Yague MT, Vazquez G, Perez-Barrios A. Collagenous colitis: the clinical and morphological features. Postgrad Med J. 1982. 58:390–395.
Article
21. Gledhill A, Cole FM. Significance of basement membrane thickening in the human colon. Gut. 1984. 25:1085–1088.
Article
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