Gastric lesions in patients with autoimmune metaplastic atrophic gastritis (AMAG) in a tertiary care setting

Jason Y. Park, Toby C. Cornish, Dora Lam-Himlin, Chanjuan Shi, Elizabeth Montgomery

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Autoimmune metaplastic atrophic gastritis (AMAG) is an early manifestation of pernicious anemia that precedes the hematologic changes by years to decades. It is associated with metaplastic changes and neoplasms, including pyloric gland adenomas (PGAs). We investigated the frequency of PGAs and other lesions in all nonconsultation gastric biopsies and resections (1988 to 2008) diagnosed as AMAG. We further selected cases confirmed as AMAG by immunohistochemical identification of the gastric body (negative gastrin) and linear and nodular enterochromaffin-like cell hyperplasia (chromogranin). From this subset, all polyps and neoplasms were reviewed. We identified a total of 41,245 patients with gastric biopsies or resections from 46.7% males and 53.3% females comprising patients self-identified as 67.0% white, 23.6% African-American, 1.4% Asian, 0.8% non-White Hispanic, and 7.2% other or unknown. AMAG was diagnosed in 461 patients (1.1%), and had the following percentages based on race: 1.1% White, 1.3% African-American, 1.4% Asian, and 2.7% non-White Hispanic. The female:male ratio was 2:1 with an overall median age at presentation of 67.0 years. Of the 461 patients with AMAG, 143 had endoscopically identifiable lesions. These lesions (n=240) consisted of 179 polyps (138 hyperplastic polyps, 20 oxyntic mucosa pseudopolyps, 18 intestinal-type gastric adenomas, and 3 PGAs), 46 well-differentiated neuroendocrine neoplasms (carcinoid), 1 gastrointestinal stromal tumor, 3 lymphomas, and 11 adenocarcinomas. In summary, AMAG occurred with similar frequency across all racial groups. Although PGAs are associated with AMAG, they remain rare in the setting of AMAG.

Original languageEnglish (US)
Pages (from-to)1591-1598
Number of pages8
JournalAmerican Journal of Surgical Pathology
Volume34
Issue number11
DOIs
StatePublished - Nov 2010

Fingerprint

Atrophic Gastritis
Tertiary Healthcare
Stomach
Adenoma
Gastric Mucosa
Polyps
Hispanic Americans
African Americans
Enterochromaffin-like Cells
Chromogranins
Biopsy
Pernicious Anemia
Neoplasms
Gastrointestinal Stromal Tumors
Gastrins
Carcinoid Tumor
Hyperplasia
Lymphoma
Mucous Membrane
Adenocarcinoma

Keywords

  • AMAG
  • autoimmune gastritis
  • autoimmune metaplastic atrophic gastritis
  • gastritis
  • pyloric gland adenoma

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine
  • Surgery

Cite this

Gastric lesions in patients with autoimmune metaplastic atrophic gastritis (AMAG) in a tertiary care setting. / Park, Jason Y.; Cornish, Toby C.; Lam-Himlin, Dora; Shi, Chanjuan; Montgomery, Elizabeth.

In: American Journal of Surgical Pathology, Vol. 34, No. 11, 11.2010, p. 1591-1598.

Research output: Contribution to journalArticle

Park, Jason Y. ; Cornish, Toby C. ; Lam-Himlin, Dora ; Shi, Chanjuan ; Montgomery, Elizabeth. / Gastric lesions in patients with autoimmune metaplastic atrophic gastritis (AMAG) in a tertiary care setting. In: American Journal of Surgical Pathology. 2010 ; Vol. 34, No. 11. pp. 1591-1598.
@article{7507cdfec16d413ab9067ea0771540e3,
title = "Gastric lesions in patients with autoimmune metaplastic atrophic gastritis (AMAG) in a tertiary care setting",
abstract = "Autoimmune metaplastic atrophic gastritis (AMAG) is an early manifestation of pernicious anemia that precedes the hematologic changes by years to decades. It is associated with metaplastic changes and neoplasms, including pyloric gland adenomas (PGAs). We investigated the frequency of PGAs and other lesions in all nonconsultation gastric biopsies and resections (1988 to 2008) diagnosed as AMAG. We further selected cases confirmed as AMAG by immunohistochemical identification of the gastric body (negative gastrin) and linear and nodular enterochromaffin-like cell hyperplasia (chromogranin). From this subset, all polyps and neoplasms were reviewed. We identified a total of 41,245 patients with gastric biopsies or resections from 46.7{\%} males and 53.3{\%} females comprising patients self-identified as 67.0{\%} white, 23.6{\%} African-American, 1.4{\%} Asian, 0.8{\%} non-White Hispanic, and 7.2{\%} other or unknown. AMAG was diagnosed in 461 patients (1.1{\%}), and had the following percentages based on race: 1.1{\%} White, 1.3{\%} African-American, 1.4{\%} Asian, and 2.7{\%} non-White Hispanic. The female:male ratio was 2:1 with an overall median age at presentation of 67.0 years. Of the 461 patients with AMAG, 143 had endoscopically identifiable lesions. These lesions (n=240) consisted of 179 polyps (138 hyperplastic polyps, 20 oxyntic mucosa pseudopolyps, 18 intestinal-type gastric adenomas, and 3 PGAs), 46 well-differentiated neuroendocrine neoplasms (carcinoid), 1 gastrointestinal stromal tumor, 3 lymphomas, and 11 adenocarcinomas. In summary, AMAG occurred with similar frequency across all racial groups. Although PGAs are associated with AMAG, they remain rare in the setting of AMAG.",
keywords = "AMAG, autoimmune gastritis, autoimmune metaplastic atrophic gastritis, gastritis, pyloric gland adenoma",
author = "Park, {Jason Y.} and Cornish, {Toby C.} and Dora Lam-Himlin and Chanjuan Shi and Elizabeth Montgomery",
year = "2010",
month = "11",
doi = "10.1097/PAS.0b013e3181f623af",
language = "English (US)",
volume = "34",
pages = "1591--1598",
journal = "American Journal of Surgical Pathology",
issn = "0147-5185",
publisher = "Lippincott Williams and Wilkins",
number = "11",

}

TY - JOUR

T1 - Gastric lesions in patients with autoimmune metaplastic atrophic gastritis (AMAG) in a tertiary care setting

AU - Park, Jason Y.

AU - Cornish, Toby C.

AU - Lam-Himlin, Dora

AU - Shi, Chanjuan

AU - Montgomery, Elizabeth

PY - 2010/11

Y1 - 2010/11

N2 - Autoimmune metaplastic atrophic gastritis (AMAG) is an early manifestation of pernicious anemia that precedes the hematologic changes by years to decades. It is associated with metaplastic changes and neoplasms, including pyloric gland adenomas (PGAs). We investigated the frequency of PGAs and other lesions in all nonconsultation gastric biopsies and resections (1988 to 2008) diagnosed as AMAG. We further selected cases confirmed as AMAG by immunohistochemical identification of the gastric body (negative gastrin) and linear and nodular enterochromaffin-like cell hyperplasia (chromogranin). From this subset, all polyps and neoplasms were reviewed. We identified a total of 41,245 patients with gastric biopsies or resections from 46.7% males and 53.3% females comprising patients self-identified as 67.0% white, 23.6% African-American, 1.4% Asian, 0.8% non-White Hispanic, and 7.2% other or unknown. AMAG was diagnosed in 461 patients (1.1%), and had the following percentages based on race: 1.1% White, 1.3% African-American, 1.4% Asian, and 2.7% non-White Hispanic. The female:male ratio was 2:1 with an overall median age at presentation of 67.0 years. Of the 461 patients with AMAG, 143 had endoscopically identifiable lesions. These lesions (n=240) consisted of 179 polyps (138 hyperplastic polyps, 20 oxyntic mucosa pseudopolyps, 18 intestinal-type gastric adenomas, and 3 PGAs), 46 well-differentiated neuroendocrine neoplasms (carcinoid), 1 gastrointestinal stromal tumor, 3 lymphomas, and 11 adenocarcinomas. In summary, AMAG occurred with similar frequency across all racial groups. Although PGAs are associated with AMAG, they remain rare in the setting of AMAG.

AB - Autoimmune metaplastic atrophic gastritis (AMAG) is an early manifestation of pernicious anemia that precedes the hematologic changes by years to decades. It is associated with metaplastic changes and neoplasms, including pyloric gland adenomas (PGAs). We investigated the frequency of PGAs and other lesions in all nonconsultation gastric biopsies and resections (1988 to 2008) diagnosed as AMAG. We further selected cases confirmed as AMAG by immunohistochemical identification of the gastric body (negative gastrin) and linear and nodular enterochromaffin-like cell hyperplasia (chromogranin). From this subset, all polyps and neoplasms were reviewed. We identified a total of 41,245 patients with gastric biopsies or resections from 46.7% males and 53.3% females comprising patients self-identified as 67.0% white, 23.6% African-American, 1.4% Asian, 0.8% non-White Hispanic, and 7.2% other or unknown. AMAG was diagnosed in 461 patients (1.1%), and had the following percentages based on race: 1.1% White, 1.3% African-American, 1.4% Asian, and 2.7% non-White Hispanic. The female:male ratio was 2:1 with an overall median age at presentation of 67.0 years. Of the 461 patients with AMAG, 143 had endoscopically identifiable lesions. These lesions (n=240) consisted of 179 polyps (138 hyperplastic polyps, 20 oxyntic mucosa pseudopolyps, 18 intestinal-type gastric adenomas, and 3 PGAs), 46 well-differentiated neuroendocrine neoplasms (carcinoid), 1 gastrointestinal stromal tumor, 3 lymphomas, and 11 adenocarcinomas. In summary, AMAG occurred with similar frequency across all racial groups. Although PGAs are associated with AMAG, they remain rare in the setting of AMAG.

KW - AMAG

KW - autoimmune gastritis

KW - autoimmune metaplastic atrophic gastritis

KW - gastritis

KW - pyloric gland adenoma

UR - http://www.scopus.com/inward/record.url?scp=78049529532&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78049529532&partnerID=8YFLogxK

U2 - 10.1097/PAS.0b013e3181f623af

DO - 10.1097/PAS.0b013e3181f623af

M3 - Article

C2 - 20975338

AN - SCOPUS:78049529532

VL - 34

SP - 1591

EP - 1598

JO - American Journal of Surgical Pathology

JF - American Journal of Surgical Pathology

SN - 0147-5185

IS - 11

ER -