Pathological Types of Gastric Ulcers

Gastric ulcers encompass a diverse range of pathological types, including benign lesions, early canceration, and advanced canceration. Among these, benign lesions typically lack distinct pathological features, whereas early and advanced canceration often exhibit dysplasia pathologically.

I. Benign Lesions

Benign lesions, such as acute simple gastritis or chronic superficial gastritis, exhibit diffuse lymphocyte infiltration within the lamina propria of the mucosa under microscopic examination, accompanied by a small amount of serous exudation. However, there is no glandular destruction or crypt architectural changes, indicative of benign pathology.

II. Early Canceration

1. Elevated Type: Characterized by a protruding lesion resembling a polyp with a broad base and soft texture.
2. Depressed Type: Manifests as a deep ulcer at the lesion center, with surrounding mucosa congested and edematous due to inflammatory reactions. It may be accompanied by nodular protrusions with a hard and tough texture.
3. Flat Type: Resembles a normal gastric ulcer in morphology but extends beyond the muscularis mucosa, featuring irregular edges and indistinct vascular patterns at the base.

III. Advanced Canceration

In the advanced stage, patients may demonstrate a tendency for malignancy or have already undergone malignant transformation. Consequently, the gastric ulcer gradually enlarges, and its surface is no longer confined to a specific region of the gastric wall but spreads to surrounding areas, infiltrating the entire stomach. Furthermore, peritoneal metastasis may occur, leading to systemic symptoms such as weight loss, fatigue, and anemia.