Clinicopathological characteristics of invasive gastric Helicobacter pylori

Jonathan Dudley, Tad Wieczorek, Martin Selig, Hoiwan Cheung, Jeanne Shen, Robert Odze, Vikram Deshpande, Lawrence Zukerberg

Research output: Contribution to journalArticlepeer-review

7 Scopus citations


Helicobacter pylori organisms have been observed deep within the stomach mucosa with an “intracellular” appearance, although the clinicopathological characteristics of such cases remain poorly understood. We analyzed 18 cases of deep mucosal H pylori and associated clinical (sex, age, history of H pylori infection, or proton pump inhibitor [PPI] use, medications, smoking, alcohol use, comorbidities, treatment response) and pathological (presence of lymphoid aggregates, intestinal metaplasia, PPI effect, active and/or chronic inflammation, quantity of invasive versus surface H pylori) characteristics. Electron microscopy was performed on 6 cases with the highest burden of invasive H pylori. Within our sample, 3 of 16 had a history of H pylori infection, 10 of 15 were receiving PPIs at the time of biopsy, and 12 of 13 had a negative posttreatment follow-up. Histology revealed that invasive H pylori were more commonly associated with chronic inflammation, in both the antrum (15/15 chronic, 8/15 acute) and fundus (17/18 chronic, 8/18 acute). Electron microscopy showed organisms within intercellular and luminal spaces, but no intracellular organisms. Deep mucosal H pylori often have an intracellular appearance but are contained within intercellular and luminal spaces and are responsive to standard therapy.

Original languageEnglish (US)
Pages (from-to)19-25
Number of pages7
JournalHuman Pathology
StatePublished - Mar 1 2017


  • Gastric ulcers
  • Gastritis
  • Helicobacter pylori
  • Proton pump inhibitor
  • Triple therapy

ASJC Scopus subject areas

  • Pathology and Forensic Medicine


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