What histologic change defines intestinal metaplasia in the stomach?

What histologic change defines intestinal metaplasia in the stomach?

• A. Replacement by hepatic-type cells.
• B. Gastric mucosa replaced by intestinal-type epithelium with goblet cells.
• C. Loss of goblet cells with hyperplasia of parietal cells.
• D. Increased density of chief cells.

Answer: (B)

Intestinal metaplasia in the stomach is when the normal gastric mucosa is replaced by intestinal-type epithelium that contains goblet cells. Goblet cells are characteristic of intestinal tissue and their appearance in the stomach signals this metaplastic transformation, usually in the setting of chronic inflammation from things like H. pylori infection. This change is clinically important because it represents a premalignant condition associated, especially for the intestinal-type gastric adenocarcinoma pathway. Other patterns described do not fit intestinal metaplasia. Replacing gastric mucosa with hepatic-type cells would be hepatic metaplasia, not intestinal. Loss of goblet cells with parietal cell hyperplasia points to atrophic changes without intestinalization. Increased density of chief cells reflects a shift toward fundic-type mucosa, not intestinal-type mucosa.

Intestinal metaplasia in the stomach is when the normal gastric mucosa is replaced by intestinal-type epithelium that contains goblet cells. Goblet cells are characteristic of intestinal tissue and their appearance in the stomach signals this metaplastic transformation, usually in the setting of chronic inflammation from things like H. pylori infection. This change is clinically important because it represents a premalignant condition associated, especially for the intestinal-type gastric adenocarcinoma pathway.

Other patterns described do not fit intestinal metaplasia. Replacing gastric mucosa with hepatic-type cells would be hepatic metaplasia, not intestinal. Loss of goblet cells with parietal cell hyperplasia points to atrophic changes without intestinalization. Increased density of chief cells reflects a shift toward fundic-type mucosa, not intestinal-type mucosa.