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Lymphocytic Gastritis: An Expression of Different Diseases

First described by Jules Haot in 1988, lymphocytic gastritis (LG) was initially believed to correspond to an entity mentioned in 1945 by the Belgian gastroenterologist François Moutier, who reported a nodular form of gastritis characterized by centrally eroded or ulcerated depressions picturesquely compared to gastric smallpox (“varioliform gastritis”) or to the tentacles of an octopus (“octopus-sucker gastritis”). Amidst the flurry of gastric pathology research that immediately followed the discovery of H. pylori it soon became clear that increased lymphocytic infiltrates in the gastric epithelium were also found in patients with celiac disease, Ménétrier’s disease, H. pylori infection, lymphocytic and collagenous colitis, and users of NSAIDs. Histologic evidence of gastric epithelial lymphocytosis has also been reported in patients with an endoscopically normal gastric mucosa.

Thus, for years lymphocytic gastritis has remained relegated to a histopathologic pattern without specificity for any particular disease entity.

One of the reasons for the failure to detect consistent clinicopathologic correlations may have been the relatively small size of the series included in most studies, in which less common associations might escape detection. Also, the spectrum of gastric pathology in the industrialized world has undergone a considerable shift over the past two decades, in part because of the dramatic decline in the prevalence of H. pylori infection and in part due to the widespread use of proton- pump inhibitors. Thus, the 1990 paradigms may no longer be valid today.

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Wallach Derma Center, Danville, Calif.

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