Qap (Anatomical Pathology) 

QAP Peer Review

AP170
Case History: M/69, Gastric ulcer at corpus
Intended diagnosis: Erosive injury of iron medication. Contributed by:JKCC
Code Diagnosis Comment Score
anonymous Active chronic gastritis, ulcer, Helicobacter-free; Brownish granules consistent with iron encrustation. (100%) Perls' stain to confirm iron deposit.  100
anonymous Stomach: parietal cell increased, suggestive with Zollinger-Ellison syndrome (please correlates with the clinical data to make a definite diagnosis) with foreign body deposit within lamina propria (reflux of intestinal content?) nil  50
anonymous Mild active chronic gastritis. Helicobacter pylori absent (see comment). Deposition of brown pigments consistent with "iron medication Associated gastric mucosal injury".  100
anonymous Chronic gastritis with crystalline iron deposition (confirm with Perl's stain); to correlate with history of iron supplement intake. nil  100
anonymous BENIGN GASTRIC ULCER with brownish material consistent with IRON. 100% Possibly related to excessive intake of iron tablets. To correlate with clinical history. Iron to be confirmed by Perls'stain.  100
anonymous Crystalline iron deposition at lamina propria, suggestive of erosive injury in patient receiving iron medication. (100%) Suggest correlation with clinical history of iron medication.  100
anonymous Gastric biopsy - Helicobacter negative chronic gastritis - Presence of golden yellow refractile material of uncertain nature 100% For clinical correlation. Possibilities of the material: 1. From medications e.g. antacids, iron supplements 2. From contrast medium 3. From refluxed bile ( the presence of few structures with complete or incomplete oval outlines being suggestive of Clonorchis ova )  70
anonymous Iron-related gastropathy To confirm the pigments to be iron by Perl's stain. Correlate with clinical history of parenteral iron therapy or intake.  100
anonymous CHRONIC GASTRITIS, NO HELICOBACTER, PRESENCE OF BROWNISH PIGMENT SUGGESTIVE OF IRON SUGGEST PEARL STAIN FOR CONFIRMATION  99
anonymous CHRONIC GASTRITIS, NO HELICOBACTER. PRESENCE OF BROWNISH PIGMENT SUGGESTIVE OF IRON 100% SUGGEST PEARL STAIN TO CONFIRM THE NATURE OF THE PIGMENT  0
anonymous Mucosal calcinosis. nil  50
anonymous Erosive injury due to iron medication nil  100
anonymous Parasitic infestation: ?Ancylostoma ?Anisakis Insufficient material for diagnosis Require stool examination for ova/larvae  0
anonymous Crystalline iron deposition in gastric mucosa Confirmed by iron stain; correlation with clinical history for iron ingestion  100
anonymous Erosion with brownish pigment suggestive of iron ingestion. 100% Probability nil  100
anonymous Exogenous iron deposition 100% Correlate with clinical history for iron supplement therapy; perform Perl's stain.  100
anonymous BENIGN ULCER, with crystalline material probably: bile 70% barium 20% iron 10% nil  70
anonymous Increased parietal cell mass/parietal cell hyperplasia suggestive of Zollinger-Ellison syndrome nil  0