GASTRITIS GLANDULARIS PROLIFERA. 369 



Gastritis Mucipara. 



As in acute gastritis, the changes are most marked in the 

 region of the pylorus. In early stages of the inflammatory 

 process there is a diffuse redness of the mucous membrane, 

 which later becomes a mottled pale gray. The mucosa is 

 swollen and covered by a tenacious layer of tough mucus. 

 Here and there are small cysts, produced by occlusion of the 

 gastric tubules. Occasionally it is studded with papillary 

 projections about the size of a pea. As in other chronic in- 

 flammations, there may be a marked increase in the connec- 

 tive-tissue stroma, w r hich results finally in atrophy of the gland- 

 ular tissue. 



It is only on microscopic examination, however, that the 

 distinctive features of this variety of chronic gastritis can be 

 noted. The number of gastric tubules in a given field is 

 much less than normal. Most characteristic is the mucoid 

 degeneration of the chief and border cells of the tubules, 

 extending to the fundus of the gland. In addition to these 

 parenchymatous changes, there is a more or less pronounced 

 cellular infiltration of the interglandular connective tissue. 

 As would naturally be expected, the gastric secretions are 

 greatly reduced in quantity and quality, and in late stages 

 even entirely wanting. 



Gastritis Glandularis Prolifera. 



This variety of chronic gastritis stands in marked contrast 

 to the one just described. The distinctive feature here is the 

 proliferative activity of the chief and parietal cells lining the 

 gastric tubules, the parietal or acid-producing cells especially 

 being greatly increased in size and number and lying in close 

 juxtaposition. These oxyntic or parietal cells may also be 

 found in the tubules of the pyloric region, where they are not 

 normally present. In some cases there seems to be a pro- 

 liferation of the glandular tubules, the entire gland becoming 

 elongated and tortuous. There may be associated with these 

 parenchymatous changes more or less cellular infiltration of 

 the interglandular connective tissue. 



The cylindrical surface-epithelium is often desquamated 



24 Hist. 



