The Churg-Strauss syndrome: diagnosed for the first time in a gastrectomy specimen

The Churg-Strauss syndrome (CSS), first described in 1951 and characterised by eosinophilic inflammation and necrotising vasculitis in patients with asthma can in principle affect any organ. We report on a 47-year-old male patient, in whom the diagnosis of CSS was finally established for the first time on the basis of the histological work-up of a gastrectomy specimen. Endoscopic inspection had revealed a rigid gastric wall and a large irregularly shaped ulcer in the prepyloric antrum. Despite the fact that no carcinoma was demonstrable in the biopsy material, a gastrectomy was nevertheless performed since the endoscopic appearance was strongly suspicious for a carcinoma. The gastrectomy specimen revealed massive eosinophilic gastritis in combination with granulomas and necrotising vasculitis--localised mainly in the muscularis propria. In view of the subsequent information that the patient also suffered from asthma, the diagnosis of CSS (previously unrecognised) was established--for the first time--in the gastrectomy specimen.