Slide 35:
❗️Chronic autoimmune gastritis.
‼️lymphocyte infilteration without formation of follicles.
no neutropils.
intestinal metapalsia.
atrophy of musculosa.
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Slide 36:
❗️Benign Peptic Ulcer.
‼Area of necrosis.
Normal thickness.
clear base.
With inverted edges.

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Slide 37:
❗️Peptic Ulcer Disease (PUD).
‼️Four zones:
1- Necrotic Zone
2- area of Acute inflammation
3- granulation tissue
4- Area of Chronic inflammation and fibrosis.
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Slide 39:
❗️Menetrier Disease.
‼️*dialted gastric pits and glands.
*Hyperplasia of faveolar cells.
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Slide 38:
❗️Menetrier Disease (Hypertrophic gatrophathy).

‼️Giant Mucosal Folds.
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⭕ Diagnosis Intestinal metaplasia in the stomach
- may be caused by Autoimmune chronic gastritis

🔶 Feature: Presence of Goblet cells

⭕ Diagnosis: Polyps in the stomach (by endoscope)

🔶 Feature: Tiny, numerous sessile massess, maybe associated with bleeding

⭕ Diagnosis: Fundic gland polyposis (FGP)
-It is not a neoplasm

🔶 Feature: presence of hyperplastic mucus secreting glands, no dysplastic changes

-Short gastric pits with superficial and deep cystic pits (اضافة)

⭕ Diagnosis: Gastric hyperplastic polyposis

🔶 Feature:
الدكتور اعتبرها نفس ال FGP

- Dilated tortuos pits with inflamed edematous stroma (اضافة)

⭕ Adenoma (Adenomatous Polyp)_is a pre-cancerous state of tumor.
🔶
-Dysplastic changes of the glands:
1- Stratification of the lining epithelium.
2- nn. at different levels and are hyperchromtic.

⭕ Diagnosis: Malignant ulcer
🔶 Feature: Everted and thickened Edges surrounding the ulcer

⭕ Diagnosis: Gastric carcinoma (gross cut section)

🔶 Feature: thickening of the stomach wall in the pyloric part

⭕ Diagnosis: Gastric adenocarcinoma

🔶 Feature: Eosinophilic glands invading the musclaris propria (may also invade other layers and other abdominal organs)

⭕ Diagnosis: Diffuse gastric adenocarcinoma (Signet ring carcinoma)

🔶 Feature: Signet ring cells with abundant cytoplasm

⭕ Diagnosis: Neuroendocrine tumor (Carcinoid tumor)

🔶 Feature: Nests of cells, the nuclei of the cells are characterized by the presence of light and dark chormatin "Salt and Pepper nuclear chromatin"

⭕ Diagnosis: Gastrointestinal stromal Tumor (GIST) may be benign or malignant

🔶 Feature: the presence of :-
-Spindle shaped cells (the arrow in the 1st picture) or Vacuoles which indicates cells with clear cytoplasm (the arrow in the 2nd picture)

⭕ Diagnosis: Lymphoma

🔶 Feature:
1-Lympho-Epithelial lesion, it contains clusters of lymphocytes (5 to 6) inside the epithelium of the glands.
2-Diffuse lymphocytes in the whole section.


Note: Lymphoma should be differentiated from chronic inflammation.
- In inflammation only one lymphocyte may present in the lesion with a lot of neutrophils.

⭕ Diagnosis: Lymphoma

🔶 Feature:
-Atypical lymphocytes with little cytoplasm (normally lymphocytes have no cytoplasm) arranged in a rossette pattern.
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⭕ Normal small intestine

🔶 Feature: Villi (finger like projections used for absorption)

⭕ Large intestine (longitudinal and horizontal sections)

🔶 Feature: Crypts

⭕ Ganglion cells "found inside the nerve bundle"

🔶 Feature: Large cells with basophilic cytoplasm and eccentric nucleus. (Arrow)