How can there be a term called intestinal metaplasia of stomach

  1. How can there be a term called "intestinal metaplasia" of stomach

    Hello everyone,

    Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal metaplasia", due to gastrititis. Now intestine also has simple columnar epithelium. So in this case it has gone from columnar to columnar, so how can there be any metaplasia here. Also in gastritis why does stomach epithelium change, naturally its epithelium is able to withstand acid. Thanks!!
     
  2. jcsd
  3. atyy

    atyy 11,043
    Science Advisor

    Google suggests http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2895407/

    "Matsukura et al. based their classification of IM on the presence of small intestinal digestive enzymes. In complete-type IM, most or all of these enzymes are expressed. In incomplete-type IM, these enzymes are absent or only partially expressed. ... Complete metaplasia is currently diagnosed when the epithelium resembles the small intestinal phenotype, with eosinophilic enterocytes displaying a well-defined brush border (representing absorptive microvilli) and well-formed goblet cells. Paneth cells may also be present. Incomplete metaplasia resembles a colonic epithelium phenotype with multiple, irregular mucin droplets of variable size in the cytoplasm and absence of a brush border (Figure 1)."

    "Another classification, used in research but not in routine clinical practice, combines the morphologic characteristics described for complete and incomplete types with analysis of the types of mucins expressed. Histochemically, normal gastric mucins are pH neutral, and they stain magenta with periodic acid–Schiff (PAS). In IM, acid mucins replace the original gastric mucins and are stained blue with Alcian blue (AB) at pH 2.5. "
     
    Last edited: May 21, 2013
  4. Thanks for the answer :smile: While it is not entirely clear for me. I understood that that there is a difference between gastric and intestinal epithelium, even though they both have columnar epithelium.
     
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