Low Grade Glandular Dysplasia: What Your Biopsy Results Mean - Gastroenterology and Hepatology

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Dysplasia


I received a report after my gastroscopy.
Does this indicate cancer? The report states: 1.
CLINICAL DIAGNOSIS: Gastric ulcer scar.
2.
DIAGNOSIS: Stomach, endoscopic biopsy—Low grade glandular dysplasia.
3.
GROSS DESCRIPTION: The specimen fixed in formalin consists of a piece of tan tissue measuring 0.2 cm.
All for section.
4.
MICROSCOPIC DESCRIPTION: Sections show eroded gastric mucosal tissue with focal mild glandular dysplasia in a few aggregates of small distorted glands lined by cells with mitotic activity, mild nuclear hyperchromasia, and nucleomegaly, in addition to complete intestinal metaplasia and sparse infiltration of inflammatory cells.
Helicobacter pylori is not found.
Close follow-up with repeat biopsy, as necessary, is suggested.

Wei, 30~39 year old female. Ask Date: 2021/01/24

Dr. Zhang Kebin reply Gastroenterology and Hepatology


Hello Mr.
Wei! Your biopsy results from the gastroscopy indicate low-grade glandular dysplasia.
According to the progression of gastric cancer: normal -> intestinal metaplasia -> low-grade dysplasia -> high-grade dysplasia -> gastric cancer, your condition is not classified as cancer yet.
However, it is uncertain what was found during the gastroscopy, as it is possible that the cancerous area was not sampled.
I recommend discussing follow-up treatment and monitoring with your attending physician.
Thank you for your inquiry!

Reply Date: 2021/01/24

More Info


Understanding your biopsy results can be quite daunting, especially when terms like "low-grade glandular dysplasia" are involved. Let's break down what this means in the context of your diagnosis and the implications for your health.


What is Low-Grade Glandular Dysplasia?
Low-grade glandular dysplasia refers to abnormal changes in the cells of the gastric mucosa (the lining of the stomach). In your biopsy report, the presence of "focal mild glandular dysplasia" indicates that there are some areas within the gastric tissue where the cells are not entirely normal but are not yet cancerous. This condition is often considered a precancerous state, meaning that while it is not cancer, it has the potential to progress to cancer if left unchecked.


Key Findings from Your Report
1. Eroded Gastric Mucosal Tissue: This suggests that there is some damage to the stomach lining, which could be due to various factors such as chronic inflammation, infection, or irritation.


2. Mild Glandular Dysplasia: The report mentions "small distorted glands lined by cells with mitotic activity," which indicates that some cells are dividing more than normal. However, since it is classified as low-grade, the changes are not severe.

3. Complete Intestinal Metaplasia: This term means that some of the stomach lining cells have changed to resemble intestinal cells. This is often a response to chronic irritation or inflammation and can be associated with an increased risk of gastric cancer.

4. Inflammatory Cells: The presence of sparse inflammatory cells suggests that there is some level of inflammation, which is common in conditions affecting the stomach lining.

5. Helicobacter Pylori: The report indicates that this bacterium, which is often linked to gastric ulcers and cancer, was not found in your biopsy. This is a positive sign, as H. pylori infection can exacerbate dysplastic changes.


What Does This Mean for You?
While low-grade glandular dysplasia is not cancer, it is essential to monitor this condition closely. The recommendation for "close follow-up with repeat biopsy, as necessary," is crucial. Regular monitoring allows for early detection of any progression towards higher-grade dysplasia or cancer.

Next Steps
1. Follow-Up Appointments: Ensure you have regular follow-ups with your healthcare provider. They may recommend repeat endoscopies and biopsies to monitor the condition of your gastric mucosa.

2. Lifestyle Modifications: Consider dietary changes, reducing alcohol consumption, and avoiding nonsteroidal anti-inflammatory drugs (NSAIDs) that can irritate the stomach lining. A diet rich in fruits, vegetables, and whole grains may help support gastric health.

3. Symptom Monitoring: Be vigilant about any new symptoms such as persistent abdominal pain, changes in appetite, or gastrointestinal bleeding, and report these to your healthcare provider promptly.

4. Education: Understanding your condition is vital. Ask your healthcare provider for more information about low-grade dysplasia and what it means for your long-term health.


Conclusion
In summary, while your biopsy results indicate low-grade glandular dysplasia, which is a precancerous condition, it is not cancer. The key to managing this condition is regular monitoring and follow-up with your healthcare provider. By staying informed and proactive about your health, you can effectively manage this condition and reduce the risk of progression to cancer. Always feel free to reach out to your healthcare team with any questions or concerns you may have regarding your diagnosis and treatment plan.

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