2026 Volume 64 Issue 1 Pages 42-49
Autoimmune gastritis (AIG) is characterized by severe atrophy in the fundic gland region and can be associated with pernicious anemia, neuropathy, gastric neuroendocrine tumors (NETs), and gastric cancer. Recent reports indicate that the prevalence of AIG is not negligible. Therefore, it is important to evaluate AIG-associated findings in gastric X-ray images. In this review, we summarize radiographic findings characteristic of AIG, including severe mucosal atrophy, reversed atrophy, sticky adherent dense mucus, residual fundic glands (raised type), and newly proposed sporadic granular polyps and regular small polygonal mucosal patterns. These findings are useful for distinguishing AIG from Helicobacter pylori (H. pylori)-associated gastritis or H. pylori-uninfected normal stomach. Some of them exhibit high specificity for AIG.
Currently, few medical facilities perform AIG diagnosis based on gastric X-ray findings. I hope this review is useful for improving the detection of AIG, especially when chronic gastritis findings different from H. pylori-infected gastritis are observed. Further validation of X-ray findings concerning AIG is anticipated through multicenter studies.
