Lymphocytic gastritis: a newly described entity: a retrospective endoscopic and histological study.

Abstract

SUMMARY Lymphocytic gastritis is a histopathological entity characterised by the accumulation of small lymphocytes in the surface and foveolar epithelium. In order to investigate the correlation between endoscopy and histology in this condition, 192 observations selected on the basis of a presumed diagnosis of erosive or varioliform gastritis were reviewed. Ninety two instances corresponded to lymphocytic gastritis, while 100 did not show any particular microscopic feature and were labelled non-specific gastritis. There was a good correlation (48 of 58) between the diagnosis of the so-called varioliform gastritis and the histological evidence of lymphocytic gastritis. The correlation was even better when nodules, erosions, and enlarged folds were considered. Lymphocytic gastritis has a typical endoscopical appearance consisting of nodules, erosions, and large folds predominating in the gastric body. This contrasts with non-specific gastritis, which affects the antrum and produces erosions on a flat mucosa.We have previously described a histopathological form of gastritis characterised by a dense epithelial lymphocytic infiltration. Using this criterion for further research, this entity has been labelled 'lymphocytic gastritis'.'Our preliminary investigations have suggested the presence of a correlation between lymphocytic gastritis and the endoscopical features of nodules, thickened rugal folds, and erosions. These features appeared unusual and different from those seen in chronic gastritis.23The aims of the present retrospective study are to evaluate the correlation between endoscopic erosive or nodular forms of gastritis and the histological picture of lymphocytic gastritis, and to define the basic endoscopical lesions indicating a diagnosis of lymphocytic gastritis. Methods MATERIALThis retrospective study is based on the cases of

Morphological and functional restoration of parietal cells in Helicobacter pylori associated enlarged fold gastritis after eradication

“…The assessment of gastric atrophy was scored by two pathologists using a number of selected gastric biopsy specimens on a scale of 0 to 3 on the basis of the proportion of glandular loss 415 Lymphocytic gastritis was diagnosed when the number of intraepithelial lymphocytes was 30% or more of the number of epithelial cells in the areas of high lymphocyte concentration 16…”

Healing of Lymphocytic Gastritis by Eradication of <i>Helicobacter pylori</i>

“…These CD3+ T-lymphocytes may (1) be attracted by an increase in local MHC class I expression [5], (2) express CD8 in 80% of the T lymphocytes, and (3) often produce TIA 1 and granzyme B [6, 7], thus rendering them potentially cytotoxic. Endoscopically, three different findings have been described for lymphocytic gastritis: (1) Normal, or only slightly inflamed, mucosa [8]; (2) Varioliform gastritis with multiple raised chronic erosions – also known as ‘gastritis en nappes’ in the fundus and corpus [1, 2, 3, 8, 9, 10, 11, 12, 13]. (3) Hypertrophic gastritis in the fundus and corpus, with and without a gastric protein-losing syndrome [14, 15, 16, 17].…”

Collagenous Gastritis: A Case Report, Morphologic Evaluation, and Review

“…The mean intraepithelial lymphocyte count was 61.5 per 100 epithelial cells when 10 random high-power fields were counted in each of the five gastric biopsy pieces. The upper limit of normal for gastric intraepithelial lymphocytes is 4 to 7 per 100 epithelial cells with more than 25 per 100 epithelial cells considered diagnostic of lymphocytic gastritis (19). Di Giacomo et al (20) found a mean of 40.6 intraepithelial lymphocytes per 100 epithelial cells in children who had a diagnosis of lymphocytic gastritis.…”