Alimentary System

Stomach, Forestomach - Necrosis

Narrative
Comment:
Necrosis is characterized by nuclear changes of pyknosis, karyorrhexis, karyolysis, or absence of nucleus in the later stage of karyolysis. The cytoplasm in early necrosis is homogenous pink in H&E sections. Degradation of cytoplasmic proteins eventually gives the necrotic cell a pale, ghostlike appearance. Necrotic cells usually lose their adherence to basement membranes and neighboring cells. Rupture of cells with loss of cell integrity is the most obvious evidence of cell death. Necrosis of the forestomach mucosa is rarely seen except in treated rats. As shown in Figure 1image opens in a pop-up window, Figure 2image opens in a pop-up window, Figure 3image opens in a pop-up window, and Figure 4image opens in a pop-up window, chemical-related lesions in the forestomach of mice and rats include necrosis and ulceration. Necrosis of the forestomach is more frequent in gavage studies than in dosed-feed or inhalation studies in rats. Thrombosis can result in necrosis (infarction) of the stomach (Figure 4image opens in a pop-up window, arrow).
Recommendations:
Necrosis of epithelium is diagnosed instead of erosion and ulcer if the necrotic epithelium is still present and at least partially attached to the underlying lamina propria or if the necrosis is not particularly centered on the epithelium of the forestomach (i.e., involves the wall primarily). If the necrosis is consistent with ischemia secondary to thrombosis (infarction), the narrative should state this, even if the thrombus is not in the plane of the section. Severity grading would depend on the overall size of the lesion and number of areas affected. While hemorrhage, edema, fibrosis, or inflammation may be associated with necrosis, these are usually not recorded separately but can be described in the narrative. If they are a prominent component of a necrotic lesion, they should be diagnosed separately.
References:

Brown HR, Hardisty JF. 1990. Oral cavity, esophagus and stomach. In: Pathology of the Fischer Rat (Boorman GA, Montgomery CA, MacKenzie WF, eds). Academic Press, San Diego, CA, 9-30.

Abstract: https://www.ncbi.nlm.nih.gov/nlmcatalog/9002563

Leininger JR, Jokinen MP, Dangler CA, Whiteley LO. 1999. Oral cavity, esophagus, and stomach. In: Pathology of the Mouse (Maronpot RR, ed). Cache River Press, St Louis, MO, 29-48.

Abstract: http://www.cacheriverpress.com/books/pathmouse.htm

Myers RK, McGavin MD. 2007. Cellular and tissue responses to injury. In: Pathologic Basis of Veterinary Disease, 4th ed (McGavin MD, Zachary JF, eds). Mosby, St Louis, MO, 3-62.

National Toxicology Program. 1994. NTP TOX-40. Toxicity Studies of beta-Bromo-beta-nitrostyrene (CAS No. 7166-19-0) Administered by Gavage to F344/N Rats and B6C3F1 Mice. NTP, Research Triangle Park, NC.

Abstract: https://ntp.niehs.nih.gov/go/14810

National Toxicology Program. 1996. NTP TR-383. Toxicology and Carcinogenesis Studies of 1-Amino-2,4-dibromoanthraquinone (CAS No. 81-49-2) in F344/N Rats and B6C3F1 Mice (Feed Studies). NTP, Research Triangle Park, NC.

Abstract: https://ntp.niehs.nih.gov/go/11305
  • Image of necrosis in the forestomach from a female B6C3F1 mouse in a chronic study

    Stomach, Forestomach - Necrosis in a female B6C3F1 mouse from a chronic study. There is loss of cellular detail indicative of necrosis (arrow).

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Stomach, Forestomach - Necrosis in a female B6C3F1 mouse from a chronic study. There is loss of cellular detail indicative of necrosis (arrow).
Stomach, Forestomach - Necrosis in a female B6C3F1 mouse from a chronic study (higher magnification of Figure 1). There is loss of cellular detail indicative of necrosis (arrow).
Stomach, Forestomach - Necrosis in a male F344 rat from a chronic study. There is loss of cellular detail and nuclei indicative of necrosis (arrow).
Stomach, Forestomach - Necrosis in a male F344 rat from a chronic study (higher magnification of Figure 3). There is loss of cellular detail and nuclei indicative of necrosis (arrow).

Authors:

Linda H. Kooistra, DVM, PhD, DACVP
Pathologist
Charles River Laboratories, Inc.
Research Triangle Park, NC

Abraham Nyska, DVM, Diplomate ECVP, Fellow IATP
Expert in Toxicologic Pathology
Visiting Full Professor of Pathology
Sackler School of Medicine, Tel Aviv University Timrat Israel

Reviewers:

Joel R. Leininger, DVM, PhD
Senior Pathologist
MedImmune
Washington, DC

Amy Brix, DVM, PhD, DACVP
Senior Pathologist
Experimental Pathology Laboratories, Inc.
Research Triangle Park, NC