Collagenous gastritis, hyperplastic polyp, and intraepithelial duodenal lymphocytosis in a 15-year-old child: An iconographic case report
Abstract
RATIONALE: Collagenous gastritis is an uncommon condition initially identified in 1989 by Colletti and Trainer, characterized by a subepithelial collagen band exceeding 10 μm in thickness. Two patient subgroups have been identified: children and young adults exhibiting severe anemia with illness confined to the gastric mucosa and no colonic involvement, and older individuals presenting with watery diarrhea and collagenous gastritis linked to collagenous colitis. A combination of hyperplastic polyps and Marsh I duodenal lymphocytosis has not been fully reported yet.
PATIENT CONCERNS: A 15-year-old boy exhibited a prolonged history of fatigue, lethargy, weight reduction, and poor development. He exhibited iron deficiency anemia. Previous oral iron supplementation had been ineffective, necessitating the use of intravenous iron infusions. An endoscopy revealed a nodular, polypoid stomach with small polyps located in the antrum.
DIAGNOSES: Biopsies revealed characteristics of collagenous gastritis, characterized by a thickened subepithelial band. A polyp exhibited elongated, architecturally distorted pits with outpouchings, cystic dilation, and papillary formation but without dysplasia. Intraepithelial lymphocytes exceeding 30 per 100 epithelial cells were seen in the small intestine. In our patient, pericryptal fibroblasts, inflammatory cells, and a distinctive subepithelial band made of randomly oriented collagen fibers were shown histologically and ultrastructurally.…
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