Lymphocytic gastritis: a study of its frequency and review of the literature

Lymphocytic gastritis is currently recognized as a special type of chronic gastritis characterized by a large number of intraepithelial lymphocytes in antral or oxyntic mucosa. The frequency of lymphocytic gastritis rarely exceeds 5% of the histologic diagnosis of gastric biopsies. This diagnosis can be easily made by intraepithelial lymphocyte counts in preparations stained with hematoxylin and eosin. Very little is known about the etiopathogeny, clinical significance and evolution of the disease. The objective of the present study was to investigate the frequency of lymphocytic gastritis in gastric mucosa biopsies from the antrum and body in patients submitted to upper digestive endoscopy in Belo Horizonte, MG, Brazil. Histological sections of antral and oxyntic mucosa from 400 patients with no gastric ulcer or neoplasia of the gastrointestinal tract were analyzed retrospectively. The following lymphocyte numbers per 100 epithelial cells were obtained: 0 a 5 lymphocytes in 366 patients (91.5%); 6 to 15 lymphocytes in 22 patients (5.5%); 16 to 29 lymphocytes in eight patients (2.0%), and 30 or more lymphocytes in four patients (1%). Patients with 30 or more lymphocytes were considered to have lymphocytic gastritis. Three of these four cases with lymphocytic gastritis presented an endoscopic diagnosis of enanthematous pangastritis, and one presented erosive pangastritis.