Unidentified Curved Bacilli on Gastric Epithelium in Active Chronic Gastritis
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چکیده
SIR,-Gastric microbiology has been sadly neglected. Half the patients coming to gastroscopy and biopsy show bacterial colonisation of their stomachs, a colonisation remarkable for the constancy of both the bacteria involved and the associated histological changes. During the past three years I have observed small curved and S-shaped bacilli in 135 gastric biopsy specimens. The bacteria were closely associated with the surface epithelium, both within and between the gastric pits. Distribution was continuous, patchy,’ or focal. They were difficult to see with haematoxylin and eosin stain, but stained well by the WarthinStarry silver method (figure). I have classified gastric biopsy findings according to the type of inflammation, regardless of other features, as "no inflammation", "chronic gastritis" (CG), or "active chronic gastritis" (ACG). CG shows more small round cells than normal while ACG is characterised by an increase in polymorphonuclear neutrophil leucocytes, besides the features of CG. It was unusual to find no inflammation. CG usually showed superficial oedema of the mucosa. The leucocytes in ACG were usually focal and superficial, in and near the surface epithelium. In many cases they only infiltrated the necks of occasional gastric glands. The superficial epithelium was often irregular, with reduced mucinogenesis and a cobblestone surface. When there was no inflammation bacteria were rare. Bacteria
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تاریخ انتشار 2003