A case of collagenous gastritis resembling nodular gastritis in endoscopic appearance |
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Authors: | Jun Tanabe Masakazu Yasumaru Masahiko Tsujimoto Hideki Iijima Satoshi Hiyama Akira Nishio Yoshiaki Sasayama Naoki Kawai Masahide Oshita Takashi Abe Sunao Kawano |
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Affiliation: | 1. Teramoto Memorial Nishitenma Clinic, AS Building 3F, 3-13-20 Nishitenma, Kita-ku, Osaka, 530-0043, Japan 2. Sankei Health Insurance Society Clinic, Osaka, Japan 3. Department of Pathology, Osaka Police Hospital, Osaka, Japan 4. Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Suita, Japan 5. Department of Gastroenterology, Teramoto Memorial Hospital, Kawachinagano, Japan 6. Endoscopy Center, Osaka Police Hospital, Osaka, Japan 7. Department of Internal Medicine, Osaka Police Hospital, Osaka, Japan 8. Department of Gastroenterology, Takarazuka Municipal Hospital, Takarazuka, Japan 9. Hankyu Corp. Clinic, Nishinomiya, Japan
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Abstract: | A 25-year-old Japanese female was referred to our clinic for the investigation of moderate iron-deficiency anemia and epigastralgia. Endoscopic examination showed diffuse mucosal nodules in the gastric body resembling nodular gastritis, but this pattern was not observed in the antrum. Histology of the gastric biopsies taken from the gastric body showed mild atrophic mucosa with chronic active inflammation. Some of the biopsy specimens showed deposition of patchy, band-like subepithelial collagen. Four years later, the patient showed no clinical symptoms and signs. A follow-up endoscopic examination showed similar findings, which mimicked pseudopolyposis or a cobblestone-like appearance. The biopsy specimens from the depressed mucosa between the nodules revealed a thickened subepithelial collagen band with no improvement, which led to a diagnosis of collagenous gastritis. Treatment with oral administration of proton-pump inhibitors and histamine-2-receptor antagonists had proved ineffective. To make a correct diagnosis of collagenous gastritis, we should determine the characteristic endoscopic findings and take biopsies from the depressed mucosa between the nodules. |
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