What is Intestinal Metaplasia?

Stomach Metaplasia
Histology of gastric foveolar metaplasia, gastric heterotopia, and normal duodenal mucosa. (A–C) Gastric foveolar metaplasia. Gastric foveolar-type epithelium exhibiting remarkable hyperplasia (A). Note the surface papillary projections lined by gastric foveolar-type epithelium. The lining epithelium shows an apical mucin cap (arrowheads; B), which is positive for periodic-acid Schiff (PAS) staining (C). (D, E) Gastric foveolar metaplasia with active inflammation. Note the intraepithelial neutrophils (arrowheads; D). Epithelium showing PAS-positive apical mucin (E). (F, G) Gastric heterotopia. Oxyntic glands (arrowheads) are present beneath the gastric foveolar-type epithelium showing foveolar hyperplasia (F). Closely packed oxyntic glands consisting of parietal and chief cells (G). (H, I) Normal duodenal mucosa. Villi lined by intestinal epithelium with a brush border. Goblet cells are intermingled with the absorptive cells (H). The brush border is positive for PAS staining (purple, arrowheads), whereas the goblet cells are positive for Alcian blue (blue, arrows; I). Scale bars indicate 400 μm in (A and F) and 100 μm in (B–E and G–I). Activating GNAS and KRAS mutations in gastric foveolar metaplasia, gastric heterotopia, and adenocarcinoma of the duodenum. Matsubara A, Ogawa R, Suzuki H, Oda I, Taniguchi H, Kanai Y, Kushima R, Sekine S - British journal of cancer (2015). Not Altered. CC.

Intestinal metaplasia is a precancerous change of the mucosa of the stomach with intestinal epithelium and is associated with an increased risk of dysplasia and cancer.

What is the Pathology of Intestinal Metaplasia?

The pathology of intestinal metaplasia is:

-Etiology: The cause of intestinal metaplasia are smoking, H. pylori infection, genetics having a close, first-degree relative with gastric cancer, environmental factors.

-Genes involved: SOX2, CDX.

-Pathogenesis: The sequence of events that lead to intestinal metaplasia are the replacement of one differentiated somatic cell type with another differentiated somatic cell type in the same tissue. Typically, metaplasia is triggered by environmental stimuli, which may act in concert with the deleterious effects of microorganisms and inflammation.

-Histology: The histology associated with intestinal metaplasia shows chronic inflammation due to Helicobacter pylori infection.

How does Intestinal Metaplasia Present?

Patients with intestinal metaplasia typically are both male or female at any age. The symptoms, features, and clinical findings associated with intestinal metaplasia include: acid reflux, ulcers, gastritis, or gastroesophageal reflux disease.

How is Intestinal Metaplasia Diagnosed?

Intestinal metaplasia is diagnosed by upper endoscopy with biopsy.

How is Intestinal Metaplasia Treated?

Intestinal metaplasia is treated by removing the H. pylori infection completely by antibiotics.

What is the Prognosis of Intestinal Metaplasia?

The prognosis of intestinal metaplasia is poor. Intestinal metaplasia is believed to be a precancerous lesion that may lead to gastric cancer. If you have intestinal metaplasia, then your risk of getting gastric cancer is increased six times.

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Last updated on May 26, 2022