title: Clinicopathological characteristics of invasive gastric Helicobacter pylori.
abstract: 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.
authors: Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA. Electronic address: jonathan.dudley@stanford.edu.
authors: Jonathan
authors: J
authors: Dudley
authors: Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
authors: Tad
authors: T
authors: Wieczorek
authors: Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
authors: Martin
authors: M
authors: Selig
authors: Department of Pathology, Stanford University School of Medicine, Stanford, CA, USA.
authors: Hoiwan
authors: H
authors: Cheung
authors: Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
authors: Jeanne
authors: J
authors: Shen
authors: Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
authors: Robert
authors: R
authors: Odze
authors: Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
authors: Vikram
authors: V
authors: Deshpande
authors: Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
authors: Lawrence
authors: L
authors: Zukerberg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001706:Biopsy; D004359:Drug Therapy, Combination; D005260:Female; D005753:Gastric Mucosa / Q000187:drug effects / Q000382:microbiology* / Q000648:ultrastructure*; D005756:Gastritis / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology*; D016481:Helicobacter Infections / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology*; D016480:Helicobacter pylori / Q000187:drug effects / Q000472:pathogenicity / Q000648:ultrastructure*; D006801:Humans; D008297:Male; D046529:Microscopy, Electron, Transmission; D008875:Middle Aged; D011237:Predictive Value of Tests; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors
keywords: Gastric ulcers; Gastritis; Helicobacter pylori; Proton pump inhibitor; Triple therapy