Stomach

Chronic peptic ulcer

Chronic peptic ulcer

Chronic peptic ulcer (stomach) is a mucosal defect which penetrates the muscularis mucosae and muscularis propria, produced by acid-pepsin aggression. Ulcer margins are perpendicular and present chronic gastritis. During the active phase, the base of the ulcer shows 4 zones : inflammatory exudate, fibrinoid necrosis, granulation tissue and fibrous tissue. The fibrous base of the ulcer may contain vessels with thickened wall or with thrombosis. (H&E, ob. x7)



Chronic peptic ulcer (detail)
Van Gieson staining - Chronic peptic ulcer

Chronic peptic ulcer (stomach). During the active phase, the base of the ulcer shows 4 zones :

  1. inflammatory exudate - at the lumen (cell debris and neutrophils)
  2. fibrinoid necrosis (yellow in van Gieson staining and pink in H&E)
  3. granulation tissue (see Granulation tissue)
  4. mature fibrous tissue (abundant collagen - red in van Gieson staining and pink in H&E, profound, spreading beneath ulcers margins, producing mucosal retraction - radiating folds). This fibrous layer may contain vessels with thickened walls or with thrombosis. (H&E, ob. x10)
Last updated : 01/30/2009