[Pseudoneoplastic regeneration of the stomach. Histopathology and differential diagnosis].

Pseudoneoplastic regeneration has become an important differential diagnosis to gastric carcinoma. Increasing use of acetylsalicylic acid (ASA) and non-steroidal anti-inflammatory drugs (NSAIDs) appears to be related to this entity. In recent years knowledge of pseudoneoplastic regeneration has continuously improved and the proportion of this designation among cases sent to our institute for second opinion decreased from more than 50% in 2000 to approximately 10% today. In diagnostically difficult cases the gastritis status may help: the majority of patients with gastric carcinoma show either active or treated Helicobacter gastritis, whereas individuals with pseudocarcinomatous regeneration often show chemical reactive gastritis (reactive gastropathy). Gastric ulcers should always be followed-up during the healing phase. A second opinion may confirm the differential diagnosis.