Stomach biopsy for Helicobacter pylori
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Author:
Mikael Häggström [note 1]
Contents
Microscopic evaluation
Look for:
- Inflammation, typically a chronic form of gastritis with germinal centers (follicular gastritis), and plasma cells in lamina propria.[1][note 2] There should be at least 3 plasma cells facing each other to make a diagnosis of chronic gastritis.
- When there is at least (mild or) moderate gastritis, especially if relatively superficial, go to high magnification and look for Helicobacter pylori-like bacteria in the lumen. They are curved, spirochete-like bacteria, generally in the superficial mucus layer and along microvilli of epithelial cells.[1]
Perform immunohistochemistry for H. pylori in cases of moderate to severe chronic gastritis, or even just one neutrophil within the epithelium, where H. pylori is not seen on H&E stains.[2]
Example report
Stomach, biopsy: Chronic active gastritis. |
Chronic gastritis without H. pylori-like organisms can be described as non-specific:
Mild chronic gastritis, which is non-specific. Negative for H. pylori-like organisms on H&E stain. |
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
- ↑ Plasma cells and lymphocytes are normally found in the lamina propria of the small and large intestine, but is abnormal in the stomach.
Main page
References
- ↑ 1.0 1.1 Elliot Weisenberg. Stomach - Infections - Helicobacter pylori. Pathology Outlines. Topic Completed: 1 August 2012. Minor changes: 1 September 2020
- ↑ Hartman DJ, Owens SR (2012). "Are routine ancillary stains required to diagnose Helicobacter infection in gastric biopsy specimens? An institutional quality assurance review. ". Am J Clin Pathol 137 (2): 255-60. doi: . PMID 22261451. Archived from the original. .
Image sources