TY - JOUR
T1 - Clinicopathological characteristics of invasive gastric Helicobacter pylori
AU - Dudley, Jonathan
AU - Wieczorek, Tad
AU - Selig, Martin
AU - Cheung, Hoiwan
AU - Shen, Jeanne
AU - Odze, Robert
AU - Deshpande, Vikram
AU - Zukerberg, Lawrence
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Helicobacter pylori organisms have been observed deep within the stomach mucosa with an “intracellular” appearance, although the clinicopathological characteristics of such cases remain poorly understood. We analyzed 18 cases of deep mucosal H pylori and associated clinical (sex, age, history of H pylori infection, or proton pump inhibitor [PPI] use, medications, smoking, alcohol use, comorbidities, treatment response) and pathological (presence of lymphoid aggregates, intestinal metaplasia, PPI effect, active and/or chronic inflammation, quantity of invasive versus surface H pylori) characteristics. Electron microscopy was performed on 6 cases with the highest burden of invasive H pylori. Within our sample, 3 of 16 had a history of H pylori infection, 10 of 15 were receiving PPIs at the time of biopsy, and 12 of 13 had a negative posttreatment follow-up. Histology revealed that invasive H pylori were more commonly associated with chronic inflammation, in both the antrum (15/15 chronic, 8/15 acute) and fundus (17/18 chronic, 8/18 acute). Electron microscopy showed organisms within intercellular and luminal spaces, but no intracellular organisms. Deep mucosal H pylori often have an intracellular appearance but are contained within intercellular and luminal spaces and are responsive to standard therapy.
AB - Helicobacter pylori organisms have been observed deep within the stomach mucosa with an “intracellular” appearance, although the clinicopathological characteristics of such cases remain poorly understood. We analyzed 18 cases of deep mucosal H pylori and associated clinical (sex, age, history of H pylori infection, or proton pump inhibitor [PPI] use, medications, smoking, alcohol use, comorbidities, treatment response) and pathological (presence of lymphoid aggregates, intestinal metaplasia, PPI effect, active and/or chronic inflammation, quantity of invasive versus surface H pylori) characteristics. Electron microscopy was performed on 6 cases with the highest burden of invasive H pylori. Within our sample, 3 of 16 had a history of H pylori infection, 10 of 15 were receiving PPIs at the time of biopsy, and 12 of 13 had a negative posttreatment follow-up. Histology revealed that invasive H pylori were more commonly associated with chronic inflammation, in both the antrum (15/15 chronic, 8/15 acute) and fundus (17/18 chronic, 8/18 acute). Electron microscopy showed organisms within intercellular and luminal spaces, but no intracellular organisms. Deep mucosal H pylori often have an intracellular appearance but are contained within intercellular and luminal spaces and are responsive to standard therapy.
KW - Gastric ulcers
KW - Gastritis
KW - Helicobacter pylori
KW - Proton pump inhibitor
KW - Triple therapy
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U2 - 10.1016/j.humpath.2016.09.029
DO - 10.1016/j.humpath.2016.09.029
M3 - Article
C2 - 27771376
AN - SCOPUS:85006391761
SN - 0046-8177
VL - 61
SP - 19
EP - 25
JO - Human Pathology
JF - Human Pathology
ER -