Difference between revisions of "Helicobacter gastritis"

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Helicobacter gastritis (view source)

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{{ Infobox diagnosis
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Name      = {{PAGENAME}}
| Image      = Immunohistochemical_detection_of_Helicobacter_%281%29_histopatholgy.jpg
| Image      = Helicobacter gastritis - crop -- extremely high mag.jpg
| Width      =
| Width      =
| Caption    = Helicobacter gastritis. Helicobacter IHC.
| 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 heli
| Subtypes  = ''[[Helicobacter pylori]]'', ''Helicobacter heilmannii''
| LMDDx      = [[chronic gastritis]]
| LMDDx      = [[acute gastritis]], [[chronic gastritis]]
| Stains    = [[Diff Quik stain]]
| Stains    = [[Diff-Quik]], [[Cresyl violet stain]], [[Warthin-Starry stain]]
| IHC        = Helicobacter IHC
| IHC        = Helicobacter IHC
| EM        =
| EM        =
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| Grossing  =
| Grossing  =
| Site      = [[stomach]]
| Site      = [[stomach]]
| Assdx      = [[MALT lymphoma]], [[gastric carcinoma]], [[intestinal metaplasia of the stomach]]
| Assdx      = [[MALT lymphoma]], [[gastric carcinoma]], [[intestinal metaplasia of the stomach]], peptic ulcer, [[duodenitis]]
| Syndromes  =
| Syndromes  =
| Clinicalhx =
| Clinicalhx =
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| Prognosis  = benign
| Prognosis  = benign
| Other      =
| Other      =
| ClinDDx    = normal stomach
| ClinDDx    = [[normal stomach]]
}}
}}
'''Helicobacter gastritis''', abbreviated '''HG''', is a common form of [[gastritis]] caused by ''Helicobacter'' species.   
'''Helicobacter gastritis''', abbreviated '''HG''', is a common form of [[gastritis]] caused by ''Helicobacter'' species.   


The most common ''Helicobacter'' implicated is '''''[[Helicobacter pylori]''''', abbreviated '''[[HP]]'''.
The most common ''Helicobacter'' implicated is '''''[[Helicobacter pylori]]''''', abbreviated '''[[HP]]'''.


==General==
==General==
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**Carcinoma.
**Carcinoma.
**[[MALT lymphoma]].
**[[MALT lymphoma]].
Note:
*Historically, ''Helicobacter'' was grouped with ''Campylobacter''.<ref name=pmid21243784>{{Cite journal  | last1 = Ciortescu | first1 = I. | last2 = Stan | first2 = M. | title = [Helicobacter pylori--friend or foe?]. | journal = Rev Med Chir Soc Med Nat Iasi | volume = 114 | issue = 3 | pages = 619-24 | month =  | year =  | doi =  | PMID = 21243784 }}</ref>
**This is why it is the ''rapid urease test'', sometimes done at endoscopy, is also known as the '' Campylobacter-like organism test'', abbreviated ''CLO test''.


==Gross==
==Gross==
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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:Gastritis_helicobacter_-_high_mag.jpg | Gastritis due to HP. (WC)
Image:Gastritis_helicobacter_-_high_mag.jpg | Gastritis due to HP. (WC)
Image:Gastritis_helicobacter_-_very_high_mag_cropped.jpg | HP visible. (WC)
Image:Gastritis_helicobacter_-_very_high_mag_cropped.jpg | HP visible. (WC)
Image:Stomach_helicobacter_he.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:
- BODY-TYPE MUCOSA WITH MODERATE CHRONIC ACTIVE GASTRITIS.
- BODY-TYPE GASTRIC MUCOSA WITH MODERATE CHRONIC ACTIVE INFLAMMATION.
- ABUNDANT HELICOBACTER-LIKE ORGANISMS PRESENT.
- ABUNDANT HELICOBACTER-LIKE ORGANISMS PRESENT.
- NEGATIVE FOR INTESTINAL METAPLASIA.
- NEGATIVE FOR INTESTINAL METAPLASIA.
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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:
- ANTRAL-TYPE MUCOSA WITH MODERATE CHRONIC ACTIVE GASTRITIS.
- ANTRAL-TYPE GASTRIC MUCOSA WITH MODERATE CHRONIC ACTIVE INFLAMMATION.
- ABUNDANT HELICOBACTER-LIKE ORGANISMS PRESENT.
- ABUNDANT HELICOBACTER-LIKE ORGANISMS PRESENT.
- NEGATIVE FOR INTESTINAL METAPLASIA.
- NEGATIVE FOR INTESTINAL METAPLASIA.
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY.
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY.
</pre>
====IM present====
<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:
-- FOCAL INTESTINAL METAPLASIA.
-- ABUNDANT HELICOBACTER-LIKE ORGANISMS.
-- MODERATE CHRONIC ACTIVE INFLAMMATION.
- 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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[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Stomach]]
[[Category:Gastrointestinal pathology]]
Michael
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