Carditis
Amitabh Srivastava, MD
Key Facts
Terminology
Inflammation in proximal stomach immediately distal to anatomic GE junction
Etiology/Pathogenesis
Helicobacter pylori, autoimmune gastritis; role of GERD controversial
Macroscopic Features
Carditis related to H. pylori truly gastric in location
GERD-related carditis likely to be metaplastic epithelium in distal esophagus
Microscopic Pathology
Predominantly lymphoplasmacytic infiltration of lamina propria
Neutrophilic infiltration in H. pylori-related cases
Erosion, ulcer, or intestinal metaplasia may be present
Cases with intestinal metaplasia need to be distinguished from Barrett esophagus
 H. pylori-related carditis with mucus glands  is seen with increased lymphoplasmacytic inflammation in the lamina propria  and neutrophilic infiltration into the columnar epithelium  . |
 In this case of cardia-type mucosa in chronic gastroesophageal reflux disease, submucosal esophageal glands/ducts  indicate that this is metaplastic columnar epithelium lining the distal esophagus. |
TERMINOLOGY
Definitions
Generally refers to inflammation in proximal stomach immediately distal to anatomic gastroesophageal (GE) junction
ETIOLOGY/PATHOGENESIS
Multifactorial
Helicobacter pylori
Gastroesophageal reflux disease (GERD)
Role of GERD in carditis is controversial
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