Gastric foveolar dysplasia: a survey of reporting habits and diagnostic criteria

Stefano Serra (Lead / Corresponding author), Rola Ali, Adrian C. Bateman, Kaushik Dasgupta, Vikram Deshpande, David K. Driman, David Gibbons, Andrea Grin, Sara Hafezi-Bakhtiari, Kieran Sheahan, Amitabh Srivastava, Eva Szentgyorgyi, Rajkumar Vajpeyi, Shaun Walsh, Lai Mun Wang, Runjan Chetty

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1 Citation (Scopus)


This study aimed to ascertain views, incidence of reporting and diagnostic criteria for gastric foveolar dysplasia. A questionnaire, a post-questionnaire discussion and microscopic assessment of selected cases was conducted by gastrointestinal pathologists to explore the above-stated aims. Fifty-four percent of respondents never or rarely diagnosed gastric foveolar-type dysplasia. The general consensus was that round nuclei, lack of nuclear stratification, presence of inflammation/damage and surface maturation favoured reactive change; while architectural abnormalities/complexity and nuclear enlargement mainly were used to separate low-grade from high-grade foveolar dysplasia. Immunohistochemistry was rarely used to make the diagnosis of dysplasia and was thought not to be of help in routine practice. Inter-observer agreement in grading of dysplasia versus reactive, and the type of dysplasia (foveolar versus adenomatous), was substantial/almost perfect amongst 35.7% and 21.4% of participants, respectively. This reflects low reproducibility in making these diagnoses. In conclusion, foveolar dysplasia was a rarely made diagnosis among 14 gastrointestinal pathologists, there are no uniform criteria for diagnosis and there is poor inter-observer agreement in separating low-grade foveolar dysplasia from reactive gastric mucosa and low-grade adenomatous dysplasia. Greater awareness and agreed criteria will prevent misdiagnosis of low-grade foveolar dysplasia as reactive, and vice versa.

Original languageEnglish
Pages (from-to)391-396
Number of pages6
Issue number4
Early online date21 Apr 2017
Publication statusPublished - Jun 2017


  • Journal article
  • Gastric dysplasia
  • Foveolar dysplasia
  • Reactive atypia
  • Adenomatous dysplasia

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    Serra, S., Ali, R., Bateman, A. C., Dasgupta, K., Deshpande, V., Driman, D. K., Gibbons, D., Grin, A., Hafezi-Bakhtiari, S., Sheahan, K., Srivastava, A., Szentgyorgyi, E., Vajpeyi, R., Walsh, S., Wang, L. M., & Chetty, R. (2017). Gastric foveolar dysplasia: a survey of reporting habits and diagnostic criteria. Pathology, 49(4), 391-396.