A extreme rare clinicopathologic finding: gastric pneumatosis

Gastric pneumatosis is an unusual radiographic, computed tomographic and ex tremely rare histological finding. This is the second description of histol ogical findings associated with this disease in endoscopically obtained bio psies. We now report on a 37 year old man presenting with episodes of gastric pain and malaise. Endoscopic examination revealed many polypoid mucosa protrusi ons and microscopic examination multiple empty spaces in the lamina propria , in an otherwise intact mucosa. Some lymphocytes, plasmacells and only a f ew granulocytes were present. Helicobacter pylori couldn't be demonstrated. There were no changes of phlegmonous gastritis. The air was located in cys toid structures with a fibroblastic cell layer. This cell layer didn't have an endothelial (no expression of F VIII), epithelial or mesothelial (Cytoc eratin negativ) or histiocytic (CD68 negativ) differentiation. The symptoms cleared up without therapy. When air is detected in the gastric wall, it is important to exclude an inf ectious cause, because management and expected outcome are very different. Early gastric biopsy in these patients can establish the diagnosis.