What Are the Clinical Implications of Nodular Gastritis? Clues from Histopathology

Sökmensüer, Cenk; Önal, İbrahi̇m Koral; Yeniova, Ozgur; Ersoy, Osman; Aydınlı, Musa; Yönem, Özlem; Harmancı, Özgür; Önal, Eda Demir; Altınok, Gülçin; Batman, Figen; Bayraktar, Yusuf

doi:10.1007/s10620-009-0842-0

Cited by 13 publications

(10 citation statements)

References 7 publications

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“…This endoscopic and histopathological association had been described previously by Sokmensuer et al11 Recently, Hayashi et al evaluated the endoscopic presence of gastric yellowish-white nodules in patients using narrow banding image and magnification and found an association with H. pylori infection 12…”

Section: Discussionsupporting

confidence: 70%

Diagnostic accuracy of nodular gastritis for H. pylori infection

Romero-Flores

Fernández-Rivero

Marroquín-Fabián

et al. 2016

TCRM

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BackgroundThe term nodular is not included in the Sydney classification and there is no widely accepted histopathological definition. It has been proposed that the presence of antral nodularity could predict Helicobacter pylori (H. pylori) infection. The aim of this study was to determine the diagnostic accuracy of nodular gastritis (NG) for H. pylori infection after a rigorous standardization process, and to describe the associated histopathological characteristics.Materials and methodsEndoscopic images of patients submitted to endoscopy with biopsy sampling were included. Endoscopic images were distributed among six endoscopists. The analysis was performed sequentially in three rounds: the first round assessed the interobserver variability, the second evaluated the intraobserver variability, and the third calculated the interobserver variability after training. A correlation analysis between endoscopic and histopathological findings was performed.ResultsA total of 917 studies were included. In the first analysis of interobserver variability, a poor kappa value (0.078) was obtained. The second evaluation yielded good intraobserver variability, with kappa values of 0.62–0.86. The evaluation of interobserver variability after training revealed an improvement in the kappa value of 0.42. A correlation was found between endoscopic images and histopathological reports.ConclusionThere was a strong correlation between NG and H. pylori, but only after rigorous evaluation. The use of the term NG requires extensive standardization before it can be used clinically.

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Section: Discussionsupporting

confidence: 70%

Diagnostic accuracy of nodular gastritis for H. pylori infection

Romero-Flores

Fernández-Rivero

Marroquín-Fabián

et al. 2016

TCRM

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“…Several reports have described the histological features of NG 5,13,14,18–21 . In the present study, a histological assessment was conducted in the gastric mucosa, including not only the corpus and the antrum but also the angulus, as intestinal metaplasia is thought to originate from the gastric angulus 22 .…”

Section: Discussionmentioning

confidence: 94%

Histological features of nodular gastritis and its endoscopic classification

Nakashima¹,

Nagata²,

Watanabe³

et al. 2011

J of Digest Diseases

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OBJECTIVES:To clarify the histological features and endoscopic classifications of nodular gastritis (NG). METHODS:Overall 40 996 patients who had undergone an upper gastrointestinal endoscopy were enrolled. NG is defined as a uniform and diffuse protrusion from the antrum to angulus, which has two types at endoscopy: nodular (N) and granular (G). Three biopsy specimens were taken from the antrum, angulus and corpus. The histological features were evaluated using the updated Sydney System (USS). The topography of gastritis (antrum-predominant, pangastritis or corpus-predominant) and the prevalence of lymphoid follicles were also investigated. RESULTS:Overall 89 patients (0.22%) were diagnosed with NG, which tended to decrease in prevalence over age and predominantly affected women. All the patients were Helicobacter pylori-positive. Among these, 65 patients underwent biopsy. Activity and inflammation were mostly moderate or severe, while intestinal metaplasia and atrophy were mostly absent at all three sites. Pangastritis was the most frequent (72%) type of gastritis. Lymphoid follicles were found in 69% at the antrum, 65% at the angulus and 51% at the corpus. There were no significant differences between N and G types in clinical features, USS scores, topography of gastritis, and prevalence of lymphoid follicles. CONCLUSIONS:Atrophy and intestinal metaplasia are rare but activity and chronic inflammation are severe at the antrum, angulus and corpus in NG. Pangastritis is the commonest type of gastritis. Lymphoid follicles affect everything up to the upper corpus, contrary to endoscopic protrusion found only at angulus. There was no correlation with pathological features between N and G types.

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“…The only difference was a higher intraepithelial lymphocytosis ( p < .05). The authors postulated that intraepithelial lymphocytes may contribute to the formation of macroscopic nodules [17].…”

Section: Invasive Testsmentioning

confidence: 99%

Diagnosis of Helicobacter pylori Infection

et al. 2010

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If we had to give a general view of the articles published in the year 2010, we should conclude that the evidence in the year 2010 suggests that, also in Helicobacter pylori diagnosis, "the devil is in the details". In this sense, different studies suggested that skipping citric acid pretreatment or local validation or reducing the (13) C-urea dose markedly decreases the accuracy of the urea breath test. The studies also implied that, even between monoclonal stool tests, there are large differences between the marketed tests. Finally, even histology does not work adequately in patients with gastric cancer or extensive areas of intestinal metaplasia. In these cases, specific gastric sites should be biopsied to improve the reliability of histology.

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What Are the Clinical Implications of Nodular Gastritis? Clues from Histopathology

Cited by 13 publications

References 7 publications

Diagnostic accuracy of nodular gastritis for H. pylori infection

Diagnostic accuracy of nodular gastritis for H. pylori infection

Histological features of nodular gastritis and its endoscopic classification

Diagnosis of Helicobacter pylori Infection

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