Gastric Pseudomelanosis (Report of a Case and Review of Literature)

Gastric pseudomelanosis is exceedingly rare. To the best of our knowledge, there have been only six reported cases in the literature of gastric pseudomelanosis. We report a case of an 86 year-old woman with marked iron deficiency anemia who was found to have characteristic speckled pattern of grey-black pigmentation on endoscopic examination. Histologically, the gastric biopsy revealed characteristic aggregates of sub epithelial macrophages with coarse brown-black pigment present within the lamina propria. This pigment had focal and patchy positive staining for iron. These changes were consistent with pseudomelanosis. The previously reported six cases had similar clinicopathological features. Although the exact pathogenesis of gastric pseudomelanosis is unknown, it is benign and has not been associated with malignant transformation or worsening of any underlying medical conditions.