The clinical significance of focally enhanced gastritis

The American Journal of Surgical Pathology
Wei Xin, Joel K Greenson

Abstract

Focally enhanced gastritis (FEG) is typified by small collections of lymphocytes and histiocytes surrounding a small group of foveolae or gastric glands, often with infiltrates of neutrophils. Several studies have found that FEG is commonly seen in Crohn's disease patients with a positive predictive value of 94%. Additional studies have found that FEG is present in up to 20% of pediatric ulcerative colitis patients, suggesting that FEG is a marker for inflammatory bowel disease (IBD) in general. We reviewed all gastric biopsies from a single calendar year (1999) to study the incidence of FEG and its relationship to IBD. A total of 34 cases of FEG were found among 971 gastric biopsies from 927 patients. Only 4 FEG patients were found to have IBD (2 Crohn's, 1 ulcerative colitis and 1 chronic colitis, type indeterminate, 11.8%, positive predictive value of 5.9%). Five FEG patients were status post bone marrow transplantation (14.7%). There were no other clinical correlations and gastric histopathology did not predict which patients with FEG had IBD. We conclude that FEG is not a common histologic finding in our patient population and that the positive predictive value of this finding is much too low to be thought of as a specific...Continue Reading

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