Difference between revisions of "Stomach biopsy for Helicobacter pylori"
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− | {{Top | + | <noinclude>{{Top |
|author1=[[User:Mikael Häggström|Mikael Häggström]] | |author1=[[User:Mikael Häggström|Mikael Häggström]] | ||
|author2= | |author2= | ||
− | }} | + | }}</noinclude> |
− | + | [[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| | + | [[File:Helicobacter pylori, Gastric Mucosa, H&E (390307642).jpg|thumb|Another H&E stain.]] |
Look for: | Look for: | ||
− | * | + | *'''Inflammation''', typically a chronic form of '''[[gastritis]]''' with germinal centers (follicular gastritis), and plasma cells in lamina propria.<ref name=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=note>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. |
− | + | *When there is at least {{Moderate-begin}}mild or{{Moderate-end}} 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.<ref name=PathologyOutlines-HP/> | |
+ | 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=== | ===Example report=== | ||
{|class=wikitable | {|class=wikitable | ||
− | | | + | | Stomach, biopsy:<br> |
+ | Chronic active gastritis.<br> | ||
+ | Positive for helicobacter pylori. | ||
|} | |} | ||
− | {{Bottom}} | + | |
+ | Chronic gastritis without ''H. pylori''-like organisms can be described as non-specific: | ||
+ | {|class=wikitable | ||
+ | | Mild chronic gastritis, which is non-specific.<br> | ||
+ | Negative for ''H. pylori''-like organisms on H&E stain. | ||
+ | |}<noinclude> | ||
+ | {{Bottom}}</noinclude> |
Latest revision as of 19:30, 2 December 2022
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