Significance of Lymphoid Follicles and Aggregates in Gastric Mucosa of Children

Abstract

This study was designed to evaluate the significance of gastric lymphoid follicles (LF) and aggregates (LA) in children with and without Helicobacter pylori (HP) infection. All 605 antrum biopsies performed during 1994 were reviewed and classified according to the presence or absence of inflammation, LF, or LA. HP was searched with a DiffQuik stain in all biopsies showing gastritis, LF, or LA. Gastritis was diagnosed in 80 biopsies (16 with LF, 18 with LA and 46 without LA or LF). Identification of HP in these biopsies was as follows: (a) cases with LF: 12/16; (b) cases with LA: 3/18; (c) cases without LF or LA: 8/46. The biopsies without gastritis had a higher frequency of LA (65/525) than of LF (2/525). HP was not identified in any case without gastritis. The presence of LF with histologic gastritis had the strongest correlation with HP (R = 0.5, p < 0.00001). LF with gastritis had a positive predictive value of 75% for HP and the absence of LF had a negative predictive value of 82.8% (sensitivity 52%; specificity 92%). LA with gastritis had no significant correlation with HP. From these results we conclude that lymphoid follicles should be distinguished from lymphoid aggregates. Lymphoid follicles can rarely be present in an otherwise normal gastric mucosa; however, they are more frequently found in cases of gastritis and are strongly associated with HP infection. Lymphoid aggregates are not significantly associated with HP infection and may be a component of the normal gastric lymphoid tissue.

Gastric Mucosal Lymphoid Follicles: Histology, Distribution, Frequency, and Etiologic Features

“…9 Reportedly, they do not to occur in normal gastric mucosa 10,11 or are rare. 6,9,12 It was a surprise, then, to find them in the otherwise normal mucosa of patients with gastric stromal sarcomas in the Carney triad (gastric stromal sarcoma, pulmonary chondroma, and extraadrenal paraganglioma) 15 ; they were unexplained.…”

Clinical Characteristics and Outcomes of Gastritis Associated With Immune Checkpoint Inhibitors: Scoping Review

“…In immune-mediated colitis, a previous large-scale study including 1074 patients reported the median time of onset of 60 days (interquartile range: 28–88),34 and immune-related hepatitis was reported to occur 3–14 weeks after the introduction of these agents 37. The difference may stem from the fact that lymphoid follicles rarely exist in a normal gastric mucosa,38 and additional insults to the stomach or migration of activated T cells are speculated to be necessary to cause IMG. Comparison of endoscopic and histologic findings before and after initiation of ICIs may be beneficial to prove the hypothesis.…”

Can histopathology of gastric tissue resected in sleeve gastrectomy be informative about serum iron levels?

“…It is known that lymphoid follicles and / or aggregates are often associated with Helicobacter pylori, but may occasionally be associated with other inflammatory and neoplastic processes (Chakhachiro et al, 2020). Although it is thought that obesity being a low-grade chronic inflammatory condition (Esposito et al, 2003) which may be effective in the formation of lymphoid aggregates, there are also reports that lymphoid clusters that do not contain a germinal center are a normal component of the gastric mucosa without being associated with Helicobacter pylori (Carpentieri et al, 2000).…”