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Stomach biopsy for Helicobacter pylori

1,473 bytes added, 14:52, 22 April 2022
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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==
[[File:Helicobacter pylori, Gastric Mucosa, H&E (390307642).jpg|thumb|Dozens of the curved bacteria fill the lumen of a gastric foveola on 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-HP/> *Look for associated Associated '''inflammation''', typically a chronic inflammatory infiltrate form of '''[[gastritis]]''' with germinal centers (follicular gastritis), and plasma cells in lamina propria.<refname=PathologyOutlines-HP>{{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'' 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.<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===
{|class=wikitable
| Stomach, biopsy:<br>Chronic active gastritis.<br>Positive for helicobacter pylori.|} Chronic gastritis without ''H. pylori''-like organisms can be described as non-specific:{|class=wikitable| Mild chronic gastritis, which is non-specific.<br>Negative/Positive for ''H. pylori''-like organisms on H&E stain.
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