Follicular gastritis and its association with Helicobacter pylori infection

Fifty endoscopic biopsies with follicular gastritis (FG) were reviewed to define the frequency of association of FG and Helicobacter pylori (H pylori) infection. All biopsies were studied in sections stained with hematoxylin and eosin and no special techniques were employed. In forty-two out of the fifty cases (84%) H pylori was documented and most of the gastritis showed activity. There was no correlation between the quantity of follicles and the number of bacilli; some biopsies with few follicles showed many microorganisms and others with many follicles showed only a few. There was also no correlation between the presence of the follicles and the distribution of Helicobacter: in some biopsies the microorganisms were found in the tissue fragments with hyperplastic follicles but in others, it was observed in fragments without lymphoid follicles. The high frequency of association between FG and H pylori suggests that this microorganism has some antigenic properties that condition lymphoid tissue hyperplasia in gastric mucosa. It is concluded that the diagnosis of follicular gastritis should be considered an important finding and its presence should lead to a careful search for H pylori. In most cases the microorganism can be identified in routine sections using only hematoxylin and eosin stain.