Contributed by Robin Dietz, MD and Liron Pantanowitz, MD
A man in his mid 40s underwent esophagogastroduodenoscopy (EGD) after several months of vague abdominal pain. Random biopsies of his gastric mucosa were taken. A representative field of the antral gastric biopsy (H&E stain, high magnification) is shown in the image below (Figure 1).
Figure 1. Photomicrograph showing gastric antrum mucosa without inflammatory cells.
No obvious Helicobacter pylori (HP) organisms were identified on the H&E stain. Further testing including immunohistochemistry to rule out HP was therefore considered.