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{{ Infobox diagnosis | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | | Name = {{PAGENAME}} | ||
| Image = | | Image = Helicobacter gastritis - crop -- extremely high mag.jpg | ||
| Width = | | Width = | ||
| Caption = Helicobacter gastritis. [[H&E stain]]. | | Caption = Helicobacter gastritis. [[H&E stain]]. | ||
| Micro = helicobacter organisms, moderate chronic active gastritis (neutrophils esp. at the luminal aspect/intraepithelial, numerous plasma cell clusters) | | Micro = helicobacter organisms, moderate chronic active gastritis (neutrophils esp. at the luminal aspect/intraepithelial, numerous plasma cell clusters) | ||
| Subtypes = ''[[Helicobacter pylori]]'', ''Helicobacter heilmannii'' | | Subtypes = ''[[Helicobacter pylori]]'', ''Helicobacter heilmannii'' | ||
| LMDDx = [[chronic gastritis]] | | LMDDx = [[acute gastritis]], [[chronic gastritis]] | ||
| Stains = [[Diff-Quik]], [[Cresyl violet stain]], [[Warthin-Starry stain]] | | Stains = [[Diff-Quik]], [[Cresyl violet stain]], [[Warthin-Starry stain]] | ||
| IHC = Helicobacter IHC | | IHC = Helicobacter IHC | ||
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*Inflammation - usually ''moderate chronic active''. | *Inflammation - usually ''moderate chronic active''. | ||
**Clusters of (lamina propria) [[plasma cell]]s. | **Clusters of (lamina propria) [[plasma cell]]s. | ||
**[[Neutrophil]]s, numerous, classically intraepithelial. | **[[Neutrophil]]s, numerous, classically intraepithelial and superficial. | ||
Tips: | Tips: | ||
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*Contamination from oropharynx - bacilli straight, not associated with gastric mucosa. | *Contamination from oropharynx - bacilli straight, not associated with gastric mucosa. | ||
*[[Chronic gastritis]]. | *[[Chronic gastritis]]. | ||
*[[Acute gastritis]]. | |||
===Images=== | ===Images=== | ||
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Image:Stomach_helicobacter_he.JPG | HP gastritis. (WC) | Image:Stomach_helicobacter_he.JPG | HP gastritis. (WC) | ||
Image:Helicobacter_pylori_in_a_case_of_gastritis.jpg | HP gastritis. (WC) | Image:Helicobacter_pylori_in_a_case_of_gastritis.jpg | HP gastritis. (WC) | ||
Image:Helicobacter_pylori,_Gastric_Mucosa,_H%26E.jpg | HP gastritis. (WC) | |||
</gallery> | |||
<gallery> | |||
Image: Helicobacter gastritis -- very high mag.jpg | HP - very high mag. (WC) | |||
Image: Helicobacter gastritis -- extremely high mag.jpg | HP - extremely high mag. (WC) | |||
Image: Helicobacter gastritis - crop -- extremely high mag.jpg | HP - extremely high mag. (WC) | |||
Image: Helicobacter gastritis - ext crop -- extremely high mag.jpg | HP - extremely high mag. (WC) | |||
</gallery> | </gallery> | ||
www: | www: | ||
*[http://commons.wikimedia.org/wiki/Category:Helicobacter_gastritis Set of images - HP gastritis (WC)]. | *[http://commons.wikimedia.org/wiki/Category:Helicobacter_gastritis Set of images - HP gastritis (WC)]. | ||
*[http://gut.bmj.com/content/58/12/1669/F2.large.jpg Helicobacter heilmannii (bmj.com)].<ref>URL: [http://gut.bmj.com/content/58/12/1669.extract http://gut.bmj.com/content/58/12/1669.extract]. Accessed on: 2 March 2012.</ref> | *[http://gut.bmj.com/content/58/12/1669/F2.large.jpg Helicobacter heilmannii (bmj.com)].<ref>URL: [http://gut.bmj.com/content/58/12/1669.extract http://gut.bmj.com/content/58/12/1669.extract]. Accessed on: 2 March 2012.</ref> | ||
====Helicobacter heilmannii==== | |||
<gallery> | |||
File:Helicobacter-heilmannii.JPG | HH. (WC/Patho) | |||
File:Helicobacter-heilmannii_2.JPG | HH. (WC/Patho) | |||
File:Helicobacter-heilmannii_3.JPG | HH. (WC/Patho) | |||
</gallery> | |||
==Stains== | ==Stains== | ||
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==Sign out== | ==Sign out== | ||
===Antrum=== | |||
<pre> | |||
Stomach, Antrum, Biopsy: | |||
- Antral-type gastric mucosa with abundant HELICOBACTER-LIKE ORGANISMS | |||
and moderate chronic active inflammation. | |||
- NEGATIVE for intestinal metaplasia. | |||
- NEGATIVE for dysplasia and NEGATIVE for malignancy. | |||
</pre> | |||
===Body=== | ===Body=== | ||
<pre> | |||
Stomach, Body, Biopsy: | |||
- Body-type gastric mucosa with abundant HELICOBACTER-LIKE ORGANISMS | |||
and moderate chronic active inflammation. | |||
- NEGATIVE for intestinal metaplasia. | |||
- NEGATIVE for dysplasia and NEGATIVE for malignancy. | |||
</pre> | |||
===IELs in duodenum=== | |||
<pre> | |||
A. Duodenum, Biopsy: | |||
- Small bowel mucosa with increased intraepithelial lymphocytes, villous | |||
architecture and crypt architecture within normal limits, see comment. | |||
- NEGATIVE for acute duodenitis. | |||
- NEGATIVE for dysplasia. | |||
B. Stomach, Biopsy: | |||
- Body-type gastric mucosa with moderate chronic active inflammation | |||
and abundant HELICOBACTER-LIKE ORGANISMS. | |||
- NEGATIVE for intestinal metaplasia. | |||
- NEGATIVE for dysplasia and NEGATIVE for malignancy. | |||
COMMENT: | |||
There are approximately 45 lymphocytes/100 enterocytes. Increased intraepithelial lymphocytes (IELs) is a nonspecific finding. IELs are seen in celiac disease and inflammatory bowel disease; however, may be explained by the Helicobacter-like organisms found in the stomach. Clinical correlation is suggested. | |||
</pre> | |||
=====Alternate comment===== | |||
<pre> | |||
Comment: | |||
Focally, there are approximately 50 lymphocytes/100 enterocytes. Increased intraepithelial | |||
lymphocytes is a nonspecific finding that may be seen in a number of conditions, including | |||
infections (e.g. Helicobacter gastritis), and autoimmune disorders (e.g. Crohn's disease, celiac disease). In this case, it may be explained by the Helicobacter-like organisms found in the stomach. Clinical correlation is suggested. | |||
</pre> | |||
====Block letters==== | |||
<pre> | <pre> | ||
STOMACH, BIOPSY: | STOMACH, BIOPSY: | ||
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===Antrum=== | ===Antrum=== | ||
<pre> | |||
Stomach, Antrum, Biopsy: | |||
- Antral-type gastric mucosa with abundant HELICOBACTER-LIKE ORGANISMS, | |||
and moderate chronic active inflammation. | |||
- NEGATIVE for intestinal metaplasia. | |||
- NEGATIVE for dysplasia and NEGATIVE for malignancy. | |||
</pre> | |||
=====Alternate===== | |||
<pre> | |||
Stomach, Biopsy: | |||
- Antral-type gastric mucosa with moderate chronic active inflammation. | |||
- Abundant Helicobacter-like organisms present. | |||
- NEGATIVE for intestinal metaplasia. | |||
- NEGATIVE for dysplasia and NEGATIVE for malignancy. | |||
</pre> | |||
=====Block letters===== | |||
<pre> | <pre> | ||
STOMACH, BIOPSY: | STOMACH, BIOPSY: | ||
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====IM present==== | ====IM present==== | ||
<pre> | <pre> | ||
Stomach, Biopsy: | |||
- Antral-type gastric mucosa with: | |||
-- Focal intestinal metaplasia. | |||
-- Abundant Helicobacter-like organisms. | |||
-- Moderate chronic active gastritis. | |||
- NEGATIVE for dysplasia and NEGATIVE for malignancy. | |||
</pre> | |||
======Block letters====== | |||
<pre> | |||
STOMACH, BIOPSY: | |||
- ANTRAL-TYPE GASTRIC MUCOSA WITH: | - ANTRAL-TYPE GASTRIC MUCOSA WITH: | ||
-- FOCAL INTESTINAL METAPLASIA. | -- FOCAL INTESTINAL METAPLASIA. | ||
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-- MODERATE CHRONIC ACTIVE INFLAMMATION. | -- MODERATE CHRONIC ACTIVE INFLAMMATION. | ||
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | - NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | ||
</pre> | |||
====H. heilmannii==== | |||
<pre> | |||
Stomach, Biopsy: | |||
- Antral-type gastric mucosa with moderate chronic active inflammation. | |||
- Abundant Helicobacter-like organisms present. | |||
- NEGATIVE for intestinal metaplasia. | |||
- NEGATIVE for dysplasia and NEGATIVE for malignancy. | |||
Comment: | |||
The Helicobacter-like organisms have an appearance similar to crinkle cut French fries; this suggests the organisms are H. heilmannii. | |||
</pre> | </pre> | ||
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*[[Stomach]]. | *[[Stomach]]. | ||
*[[Chronic gastritis]]. | *[[Chronic gastritis]]. | ||
*[[Helicobacter duodenitis]]. | |||
==References== | ==References== |
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