Stomach biopsy for Helicobacter pylori

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]

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.

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

↑ 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.