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KMID : 0357919820160020187
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Korean Journal of Pathology
1982 Volume.16 No. 2 p.187 ~ p.198
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Histotopographic Study on Morphological Nature and Significance of Submucosal Epithelial Heterotopia in the Human Stomach
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송원식(宋源植)/Won Shik Song
김용일(金勇一)/서정욱(徐廷旭)/Tong Il Kim/Jeong Wook Seo
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Abstract
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One thousand consecutive autopsy and gastrectomy stomachs were investigated by
extended histotopographic method to identify the morphological nature and distribution of
submucosal epithelial heterotopia of the stomach and to clarify its histogenesis in
relation with the development of gastritis cystica profunda by determination of common
denominators between two lesions.
Submucosal epithelial heterotopia was found in 188 out of 1,000 Korean stomachs
(18.8%), and the incidence increased with age up to 25.2% or more after the sixth
decade. No single case of heterotopia was present in stomachs under the age of 20.
majority of heterotopic nests(87.2%) were composed of foveolar and/or mucous neck
cells, being participated by loose supportive tissue corresponding to the lamina propria of
the covering mucoa and in part by smooth muscle coat of muscularis mucosae origin.
The antralized portion of stomach was the principal site of those heterotopia, tut also
both anterior and posterior walls of the fundic area participated in 17% as well. The
covering mucosa of the stomach above the heterotopic nests was affected with varieties
of chronic gastritis in 88.3%, and of those, chronic atrophic(hyperplastic) gastritis
prevailed (69.1%). Disruption of muscularis mucosae above the heterotopic nests was
demonstrated in B3.5%, to leave sufficient sire of gaps through which herniation of
reconstructed mucosa occurred. The association rate of heterotopia to gastric carcinoma
was 18.8% with no statistical difference from those to benign gastric conditions,
reflecting no specific relation to gastric carcinogenesis. Similarity of histotopographic
pattern and composition between submucosal epithelial teterotopia ar.4 gastritis cystica
profunda may lead to a concept that each represents a different stage of the same
disease spectrum.
The above findings strongly support that submucosal epithelial heterotopia is a
product of an acquired gastric mucosal alteration, especially of chronic atrophic gastritis
and secondary disruption of muscularis mucosae, through which the modified mucosa by
gastritic reconstruction (Umbau) herniates into the underlying submucosa. It seems also
a basic pathogenesis of gastritis cystica profunda that the compromised excretory
pathway and mucous retention lead to subsequent cystic dilatation of submucosal
epithelial nests.
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KEYWORD
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