Stomach biopsy for Helicobacter pylori

Author: Mikael Häggström ^{[note 1]}

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]

Stomach, biopsy: Chronic active gastritis. Positive for helicobacter pylori.

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.

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