The patient went on to have a laparotomy, biopsy and closure of the perforated gastric ulcer.
Histology
MACROSCOPIC DESCRIPTION: "Four quadrants of gastric ulcer": Four biopsies 2-4mm.
MICROSCOPIC DESCRIPTION: Multiple levels examined show four small gastric biopsies. There is ulceration of gastric mucosa with near complete destruction of normal architecture. The ulcer base is covered by amorphous pink debris and the underlying mucosa contains apoptotic cells and granulation tissue composed mainly of lymphocytes and small regenerating vessels. There are few scattered normal glandular structures within the mucosa which lack atypia. Helicobacter are not seen. There is no evidence of dysplasia or malignancy.
FINAL DIAGNOSIS: Ulcerated and inflamed gastric mucosa