Stomach biopsy for Helicobacter pylori

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Author: Mikael Häggström [notes 1]


Microscopic evaluation

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

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 2] 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.

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.


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

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  1. 1.0 1.1 Elliot Weisenberg. Stomach - Infections - Helicobacter pylori. Pathology Outlines. Topic Completed: 1 August 2012. Minor changes: 1 September 2020