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Review
. 2010 Mar;105(3):493-8.
doi: 10.1038/ajg.2009.728.

Pathology of gastric intestinal metaplasia: clinical implications

Pelayo Correa  1 , M Blanca Piazuelo, Keith T Wilson
Affiliations
Review

Pathology of gastric intestinal metaplasia: clinical implications

Pelayo Correa et al. Am J Gastroenterol. 2010 Mar.
No abstract available

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Conflict of interest statement

CONFLICT OF INTEREST

Guarantor of the article: Pelayo Correa, MD.

Specific author contributions: All authors participated in the review of the literature and in the drafting and editing of the article for intellectual content and approved the final draft submitted.

Potential competing interests: None.

Figures

Figure 1
Figure 1
Photomicrographs of gastric intestinal metaplasia. (a) Complete type with well-defined goblet cells alternating with eosinophilic enterocytes displaying well-developed brush border (inset) and Paneth cells (arrow). (b) Incomplete type showing multiple intracytoplasmic mucin droplets of varying sizes and shapes, and absence of a brush border. (Hematoxylin and eosin; original magnification, ×400; inset, ×1,000.)
Figure 2
Figure 2
Histochemical staining of gastric intestinal metaplasia (IM). (a, c) Periodic acid–Schiff–Alcian blue staining. Neutral mucins are stained magenta (arrows show normal epithelium), and acid mucins are blue (or purple when combined with neutral). (b, d) Alcian blue–high-iron diamine technique differentiates acid mucins. Sialomucins are stained blue, and sulfomucins are brown. (a, b) Complete IM (type I) shows sialomucins in goblet cells, and absence of sulfomucins. (c, d) Incomplete IM (type III) with sialomucins in goblet cells and a mixture of neutral and sulfomucins in columnar cells. (Original magnification, ×400.)
Figure 3
Figure 3
Diagrammatic representation of the sequential steps in intestinal metaplasia (IM), indicating the mucin types expressed in each step. Staining intensities are represented by the symbols + to ++++.
Figure 4
Figure 4
Proposed algorithm for the management and surveillance of gastric intestinal metaplasia (IM). *Definition of extensive IM: (i) IM present in at least two gastric locations or (ii) moderate or marked IM in at least two biopsy specimens (see refs. and 36). **Definition of extensive atrophy: serum pepsinogen I (PGI) level <70 μg/l and PGI/PGII ratio <3.
See this image and copyright information in PMC

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