title: Endoscopic features of lymphoid follicles in Helicobacter pylori-associated chronic gastritis.
abstract: OBJECTIVE
  Small, round, yellowish-white nodules (YWN) are frequently observed in Helicobacter pylori-associated gastritis. The aim of the present study was to investigate the clinical significance of these YWN.
  
  
  METHODS
  Participants comprised 211 patients with H. pylori-associated gastritis, ranging in age from 23 to 86 years.
  
  
  RESULTS
  YWN were detected in 23% of participants, more frequently in women (33%) than in men (12%; P < 0.01). YWN were observed on the antral mucosa in 4.7% of cases, lesser curvature of the corpus mucosa in 20%, greater curvature of the corpus mucosa in 0.9%, and fundic mucosa in 12%. Most YWN located on the antral mucosa showed nodular type, and most YWN located on the corpus mucosa and fundic mucosa showed flat type. On magnifying endoscopy with narrow-band imaging, YWN appeared as round whitish lesions with radial or branching microvessels on the surface and hypovascular globe structures just beneath the surface of the mucosa. Targeted biopsies of YWN revealed lymphoid follicles with lymphocyte infiltration or intense inflammatory cell infiltration.
  
  
  CONCLUSIONS
  The endoscopic finding of YWN could be observed at any site of the gastric mucosa in H. pylori-associated gastritis, and represented histological lymphoid follicles.
authors.affiliation: Division of Hepatology, Department of Internal Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan; Division of Gastroenterology, Department of Internal Medicine, Tokyo Metropolitan Health and Medical Treatment Corporation Ookubo Hospital, Tokyo, Japan.
authors.forename: Seishu
authors.initials: S
authors.lastname: Hayashi
authors.forename: Jun
authors.initials: J
authors.lastname: Imamura
authors.forename: Kiminori
authors.initials: K
authors.lastname: Kimura
authors.forename: Shunichi
authors.initials: S
authors.lastname: Saeki
authors.forename: Tsunekazu
authors.initials: T
authors.lastname: Hishima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology*; D005756:Gastritis / Q000175:diagnosis* / Q000382:microbiology; D005773:Gastroscopy / Q000379:methods*; D016481:Helicobacter Infections / Q000473:pathology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008221:Lymphoid Tissue / Q000382:microbiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D062048:Narrow Band Imaging; D012189:Retrospective Studies; D014741:Video Recording; D055815:Young Adult
keywords: Helicobacter pylori infection; chronic gastritis; lymphoid follicle; narrow-band imaging (NBI); small round yellowish-white nodule