Neuroendocrine cell proliferations in gastric antral vascular ectasia

Gastric antral vascular ectasia is a recently recognized cause of chronic gastrointestinal blood loss. Immunohistochemical and electron-microscopic studies were performed on the surgically resected antrum of a patient with antral vascular ectasia. These revealed extraepithelial and intraepithelial neuroendocrine cell proliferations. Staining for a wide range of neural and endocrine markers demonstrated that these cells contain large quantities of 5-hydroxytryptamine and vasoactive intestinal polypeptide. Gastric vascular ectasia is of unknown etiology but has been associated with achlorhydria and liver cirrhosis. The findings suggest that locally released neurotransmitters may be responsible for local vasodilation and hence a propensity to bleed.