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Surgical Pathology Criteria
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Lymphocytic Gastritis

Definition

  • Pronounced lymphocytic infiltration in gastric surface epithelium

Alternate/Historical Names

  • Chronic erosive gastritis
  • Varioliform gastritis

Diagnostic Criteria

  • Prominent intraepithelial lymphocyte infiltration
    • T cell phenotype
      • Usually CD8+
    • ≥25 lymphocytes per 100 epithelial cells
    • Lymphoepithelial lesions, if present, are small, ≤3 lymphocytes
  • Lymphocytes fill lamina propria
    • Neutrophils can be seen
  • Foveolar hyperplasia, usually mild
  • Variable degeneration of surface and foveolar epithelium
  • Severe cases have nodular targetoid and eroded lesions along proximal rugae
    • Termed “varioliform gastritis”
  • May result in atrophy
  • May be associated with:
  • Endoscopic appearance ranges from normal to nodular targetoid erosions (varioliform) to giant mucosal folds resembling hypertrophic gastritis

Robert V Rouse MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342

Original posting : September 9, 2009

Differential Diagnosis

Extranodal Marginal Zone B Cell Lymphoma Lymphocytic Gastritis
Monomorphic infiltrate in lamina propria Mixed infiltrate in lamina propria
B lineage Intraepithelial lymphocytes are T lineage
Lymphoepithelial lesions may be large Lymphoepithelial lesions, if present, are small, ≤3 lymphocytes

Classification / Lists

Gastritis / Gastropathy

Bibliography

  • Noffsinger A, Fenoglio-Preiser CM, Maru D, Gilinisky N.  Gastrointestinal Diseases, AFIP Atlas of Nontumor Pathology, First Series, Fascicle 5, 2007.
  • Owen DA. Gastritis and carditis. Mod Pathol. 2003 Apr;16(4):325-41.
  • Müller H, Volkholz H, Stolte M. Healing of lymphocytic gastritis by eradication of Helicobacter pylori. Digestion. 2001;63(1):14-9.
  • Hayat M, Arora DS, Wyatt JI, O'Mahony S, Dixon MF. The pattern of involvement of the gastric mucosa in lymphocytic gastritis is predictive of the presence of duodenal pathology. J Clin Pathol. 1999 Nov;52(11):815-9.
  • Wu TT, Hamilton SR. Lymphocytic gastritis: association with etiology and topology. Am J Surg Pathol. 1999 Feb;23(2):153-8.
  • Srivastava A, Lauwers GY. Pathology of non-infective gastritis.Histopathology. 2007 Jan;50(1):15-29.
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