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# | '''Helicobacter gastritis''', abbreviated '''HG''', is a common form of [[gastritis]] caused by ''Helicobacter'' species. | ||
The most common ''Helicobacter'' implicated is '''''[[Helicobacter pylori]''''', abbreviated '''[[HP]]'''. | |||
==General== | |||
*Several Helicobacter species can cause gastritis: | |||
**''[[Helicobacter pylori]]'' - most common. | |||
**''Helicobacter heilmannii''. | |||
Epidemiologic associations - ''Helicobacter'' infections are associated with:<ref>{{Ref PBoD|814}}</ref> | |||
*Gastritis. | |||
*Peptic ulcers. | |||
*Cancer. | |||
**Carcinoma. | |||
**[[MALT lymphoma]]. | |||
==Gross== | |||
*Thickened gastric folds. | |||
*Erythema. | |||
==Microscopic== | |||
Features: | |||
*Helicobacter organisms - '''key feature'''. | |||
**''Helicobacter pylori'': | |||
***Usually have v-shape (seagull-like shape). | |||
****May have a curved shape (comma-like shape) or U-shape.<ref name=pmid21290743>{{Cite journal | last1 = Mobley | first1 = HLT. | last2 = Mendz | first2 = GL. | last3 = Hazell | first3 = SL. | last4 = Andersen | first4 = LP. | last5 = Wadström | first5 = T. | title = Basic Bacteriology and Culture | journal = | volume = | issue = | pages = | month = | year = | doi = | PMID = 21290743 | url = http://www.ncbi.nlm.nih.gov/books/NBK2444/}} </ref> | |||
**''Helicobacter heilmannii'':<ref name=pmid16224223 >{{Cite journal | last1 = Singhal | first1 = AV. | last2 = Sepulveda | first2 = AR. | title = Helicobacter heilmannii gastritis: a case study with review of literature. | journal = Am J Surg Pathol | volume = 29 | issue = 11 | pages = 1537-9 | month = Nov | year = 2005 | doi = | PMID = 16224223 }}</ref> | |||
***Corkscrew appearance. | |||
*Inflammation - usually ''moderate chronic active''. | |||
**Clusters of (lamina propria) [[plasma cell]]s. | |||
**[[Neutrophil]]s, numerous, classically intraepithelial. | |||
Tips: | |||
#One needs to look at 400x magnification. Even at 400x they are possible to miss. | |||
#*Helicobacter are damn small. They are smaller than the nucleus of the gastric foveollar cell. | |||
#Look for mucus - they preferentially reside there. | |||
#*This is usually close to the opening of the gastric pits. | |||
#Helicobacter are found in groups. When you see several that are the same size and shape you can be sure they are real. | |||
Notes: | |||
*Helicobacter can be in antrum and/or body.<ref>{{cite journal |author=Maaroos HI, Kekki M, Villako K, Sipponen P, Tamm A, Sadeniemi L |title=The occurrence and extent of Helicobacter pylori colonization and antral and body gastritis profiles in an Estonian population sample |journal=Scand. J. Gastroenterol. |volume=25 |issue=10 |pages=1010-7 |year=1990 |month=October |pmid=2263873 |doi= |url=}}</ref> | |||
*Helicobacter don't like the intestinal mucosa ''or'' mucosa that has undergone [[intestinal metaplasia]]; you're less likely to find 'em adjacent to it. In general, Helicobacter is uncommon in the context of a case with IM... but common enough that one still ought to look for it. | |||
*May be associated with G-cell hyperplasia.<ref name=pmid8680911>{{Cite journal | last1 = Kwan | first1 = CP. | last2 = Tytgat | first2 = GN. | title = Antral G-cell hyperplasia: a vanishing disease? | journal = Eur J Gastroenterol Hepatol | volume = 7 | issue = 11 | pages = 1099-1103 | month = Nov | year = 1995 | doi = | PMID = 8680911 }}</ref> | |||
DDx: | |||
*Dirt - material has a variable size. | |||
*Contamination from oropharynx - bacilli straight, not associated with gastric mucosa. | |||
*[[Chronic gastritis]]. | |||
===Images=== | |||
<gallery> | |||
Image:Immunohistochemical_detection_of_Helicobacter_%281%29_histopatholgy.jpg | H. pylori - IHC. (WC) | |||
Image:Gastritis_helicobacter_-_high_mag.jpg | Gastritis due to HP. (WC) | |||
Image:Gastritis_helicobacter_-_very_high_mag_cropped.jpg | HP visible. (WC) | |||
</gallery> | |||
www: | |||
*[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> | |||
==Stains== | |||
*[[Cresyl violet stain]] - background and organisms blue. | |||
*[[Warthin-Starry stain]] - background yellow, organisms black. | |||
==IHC== | |||
*Helicobacter pylori IHC stain +ve. | |||
Note: | |||
*Reportly also stains ''Helicobacter heilmannii''.<ref name=pmid16224223 >{{Cite journal | last1 = Singhal | first1 = AV. | last2 = Sepulveda | first2 = AR. | title = Helicobacter heilmannii gastritis: a case study with review of literature. | journal = Am J Surg Pathol | volume = 29 | issue = 11 | pages = 1537-9 | month = Nov | year = 2005 | doi = | PMID = 16224223 }}</ref> | |||
==Sign out== | |||
===Body=== | |||
<pre> | |||
STOMACH, BIOPSY: | |||
- BODY-TYPE MUCOSA WITH MODERATE CHRONIC ACTIVE GASTRITIS. | |||
- ABUNDANT HELICOBACTER-LIKE ORGANISMS PRESENT. | |||
- NEGATIVE FOR INTESTINAL METAPLASIA. | |||
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
===Antrum=== | |||
<pre> | |||
STOMACH, BIOPSY: | |||
- ANTRAL-TYPE MUCOSA WITH MODERATE CHRONIC ACTIVE GASTRITIS. | |||
- ABUNDANT HELICOBACTER-LIKE ORGANISMS PRESENT. | |||
- NEGATIVE FOR INTESTINAL METAPLASIA. | |||
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
===Micro=== | |||
The sections show antral-type gastric mucosa with abundant lamina propria plasma cells and | |||
focal intraepithelial neutrophils. Cocci and bacilli are present. Some of the bacilli | |||
are Helicobactor-like. The epithelium matures normally to the surface. No goblet cells | |||
are identified. | |||
==See also== | |||
*[[Stomach]]. | |||
*[[Chronic gastritis]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||