Six types of intraepithelial vacuoles in the human gastric mucosa

Two types of goblet cells are classically described in the literature as markers of intestinal or colonic metaplasia of the gastric mucosa. In addition to those, four types of vacuolated cells in the gastric mucosa are herein described. One type corresponded to mucus-positive goblet cells (as in classical intestinal metaplasia) but containing in addition neuroendocrine granules. Another type presented vacuolated cells with cilia. Many of the ciliated cells had negative mucus reaction. Ciliated metaplastic cells were observed in cystically dilated pyloric glands. Another type was characterized by vacuolated cells without cilia, also in pyloric glands. The latter vacuoles often adopted an infranuclear position. Finally, cells with intraepithelial vacuoles (mucus-negative) centered by a lymphocyte were recorded in foveolar cells. Possible explanations for the occurrence of the type of intraepithelial vacuoles herein described were discussed. The occurrence of various types of intraepithelial vacuoles in the gastric mucosa should be borne in mind in the histological differential diagnosis of intestinal metaplasia in the gastric mucosa in H & E routine examinations.