In metabolic syndrome with a body mass index of 27.5 kg/m², the development of pronounced compensatory-adaptive mechanisms in the active zones of the gastric mucosa results in a number of morphological alterations. These include massive lymphocytic infiltration in the areas between the fundal glands of the mucosa, the covering epithelium, the submucosal layer, and the muscular layer; sclerosed stromal structures; atrophically altered glandular cells; and the presence of coarse fibrous connective tissue components between muscle bundles. In addition, marked atrophic and metaplastic changes of the glandular epithelium are observed in the antral and fundal regions of the stomach, as well as the formation of Paneth cells in the mucosa of the pyloroantral region. Such alterations are considered precancerous conditions and represent morphological criteria that constitute a direct indication for sleeve (longitudinal) gastric resection.

Pathomorphology, stomach, metaplasia

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