Uncommon gastritis: eosinophilic, lymphocytic and granulomatous
- Lesion
Some gastritis is caused by allergy, by lymphocytes linked to coeliac disease, or by granulomas from Crohn disease, sarcoid or infection.
What it is
Beyond H. pylori, NSAIDs and autoimmunity, three patterns are recognized by the cells that dominate the biopsy. Each points to a different underlying disease, so the pathologist's label leads the clinician to the next test.
Three uncommon gastritides
| Pattern | Key cell | Where | Look for |
|---|---|---|---|
| Eosinophilic | Eosinophils in mucosa and muscularis | Antrum and pylorus | Food allergy, parasites, connective tissue disease |
| Lymphocytic | Intraepithelial T lymphocytes | Whole stomach; thick folds with tiny aphthous nodules (varioliform) | Coeliac disease |
| Granulomatous | Epithelioid granulomas | Often antrum | Crohn disease, sarcoidosis, tuberculosis and fungi |
Clinical notes
- A granuloma in a gastric biopsy should prompt stains for acid-fast bacilli and fungi; in Colombia tuberculosis and histoplasmosis are on the list.
- Lymphocytic gastritis should prompt serology for coeliac disease.
Test yourself
Think of the answer, then tap the question to see it.
Which disease is linked to a large share of lymphocytic gastritis?
Coeliac disease, in about two of every five cases.
What is the most common specific cause of granulomatous gastritis in Western populations?
Crohn disease, followed by sarcoidosis and infections.
Which allergens most often cause eosinophilic gastritis in children?
Cow milk and soy proteins.
Elsewhere in DurgiPedia
Connections
Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given.
Sources: Helicobacter Pylori (StatPearls (NCBI Bookshelf), 2025); Crohn Disease (StatPearls (NCBI Bookshelf), 2025).
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Representative model, for educational purposes only.