Difference between revisions of "Stomach biopsy for Helicobacter pylori"

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[[File:Histopathology of helicobacter pylori (annotated).jpg|thumb|Helicobacter pylori on HE stain, being curved bacteria in the lumen of a gastric foveola.]]
 
==Microscopic evaluation==
 
==Microscopic evaluation==
[[File:Helicobacter pylori, Gastric Mucosa, H&E (390307642).jpg|thumb|Helicobacter pylori on HE stain, being curved bacteria in the lumen of a gastric foveola.]]
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[[File:Helicobacter pylori, Gastric Mucosa, H&E (390307642).jpg|thumb|Another H&E stain.]]
 
Look for:
 
Look for:
 
*''Helicobacter pylori''-like '''bacteria''' in the lumen, as curved, spirochete-like bacteria, generally in the superficial mucus layer and along microvilli of epithelial cells.<ref name=PathologyOutlines/>  
 
*''Helicobacter pylori''-like '''bacteria''' in the lumen, as curved, spirochete-like bacteria, generally in the superficial mucus layer and along microvilli of epithelial cells.<ref name=PathologyOutlines/>  
 
*Associated '''inflammation''', typically a chronic form of '''[[gastritis]]''' with germinal centers (follicular gastritis), and plasma cells in lamina propria.<ref name=PathologyOutlines>{{cite web|url=https://www.pathologyoutlines.com/topic/stomachhelicobacter.html|title=Stomach - Infections - Helicobacter pylori|author=Elliot Weisenberg|website=Pathology Outlines}} Topic Completed: 1 August 2012. Minor changes: 1 September 2020</ref><ref group=notes>Plasma cells and lymphocytes are normally found in the lamina propria of the small and large intestine, but is abnormal in the stomach.</ref> There should be at least 3 plasma cells facing each other to make a diagnosis of chronic gastritis.
 
*Associated '''inflammation''', typically a chronic form of '''[[gastritis]]''' with germinal centers (follicular gastritis), and plasma cells in lamina propria.<ref name=PathologyOutlines>{{cite web|url=https://www.pathologyoutlines.com/topic/stomachhelicobacter.html|title=Stomach - Infections - Helicobacter pylori|author=Elliot Weisenberg|website=Pathology Outlines}} Topic Completed: 1 August 2012. Minor changes: 1 September 2020</ref><ref group=notes>Plasma cells and lymphocytes are normally found in the lamina propria of the small and large intestine, but is abnormal in the stomach.</ref> There should be at least 3 plasma cells facing each other to make a diagnosis of chronic gastritis.
Perform '''immunohistochemistry''' for ''H. pylori'' if there is gastritis but uncertainty whether ''H. pylori''-like bacteria are seen.
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Perform '''immunohistochemistry''' for ''H. pylori'' in cases of moderate to severe chronic gastritis where ''H. pylori'' is not seen on H&E stains.<ref name="pmid22261451">{{cite journal| author=Hartman DJ, Owens SR| title=Are routine ancillary stains required to diagnose Helicobacter infection in gastric biopsy specimens? An institutional quality assurance review. | journal=Am J Clin Pathol | year= 2012 | volume= 137 | issue= 2 | pages= 255-60 | pmid=22261451 | doi=10.1309/AJCPD8FFBJ5LSLTE | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22261451  }} </ref>
  
 
===Example report===
 
===Example report===

Revision as of 17:33, 18 August 2021

Author: Mikael Häggström [note 1]

Helicobacter pylori on HE stain, being curved bacteria in the lumen of a gastric foveola.

Microscopic evaluation

Another H&E stain.

Look for:

  • Helicobacter pylori-like bacteria in the lumen, as curved, spirochete-like bacteria, generally in the superficial mucus layer and along microvilli of epithelial cells.[1]
  • Associated inflammation, typically a chronic form of gastritis with germinal centers (follicular gastritis), and plasma cells in lamina propria.[1][notes 1] There should be at least 3 plasma cells facing each other to make a diagnosis of chronic gastritis.

Perform immunohistochemistry for H. pylori in cases of moderate to severe chronic gastritis where H. pylori is not seen on H&E stains.[2]

Example report

Chronic gastritis without H. pylori-like organisms should be described as non-specific:

Mild chronic gastritis, which is non-specific.

Negative for H. pylori-like organisms on H&E stain.

Notes

  1. Plasma cells and lymphocytes are normally found in the lamina propria of the small and large intestine, but is abnormal in the stomach.
  1. 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.

Main page

References

  1. 1.0 1.1 Elliot Weisenberg. Stomach - Infections - Helicobacter pylori. Pathology Outlines. Topic Completed: 1 August 2012. Minor changes: 1 September 2020
  2. 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:10.1309/AJCPD8FFBJ5LSLTE. PMID 22261451. Archived from the original. . 

Image sources