Müller H, Rappel S, Volkholz H, Stolte M
Institut für Pathologie, Klinikum Bayreuth, 95445 Bayreuth.
Pathologe. 2001 Jan;22(1):56-61. doi: 10.1007/s002920000434.
Lymphocytic gastritis, first described by Haot et al. in 1986, is a very rare form of gastritis (0.8-1.6% of cases) with unclear pathogenesis. On endoscopy, lymphocytic gastritis may present either a normal appearance, such as gastritis varioliformis with multiple elevated chronic erosions in the corpus and fundus, or as a giant fold gastritis in the corpus and fundus. This type of gastritis is diagnosed histologically based on an accumulation of intraepithelial lymphocytes (more than 25/100 epithelial cells) in the surface cells of the gastric mucosa. Its etiopathogenesis is currently thought to be a sprue-associated reaction or an atypical reaction to Helicobacter pylori infection. Some studies report the lymphocytic gastritis in almost 45% of cases of sprue, with the gastritis regressing in response to a gluten-free diet, while others report a correlation of lymphocytic gastritis with serologically and/or histologically confirmed H. pylori infection, with the lymphocytic gastritis being cured by H. pylori eradication treatment in a high percentage of the cases. It is possible that a similar abnormal immune reaction to an inflammatory agent underlies both pathological entities, sprue and lymphocytic gastritis--in the one case gluten and in the other H. pylori--which would mean that sprue-induced and H. pylori-induced forms of lymphocytic gastritis exist side by side.
淋巴细胞性胃炎于1986年由豪特等人首次描述，是一种非常罕见的胃炎形式（占病例的0.8 - 1.6%），发病机制尚不清楚。在内镜检查中，淋巴细胞性胃炎可能表现为正常外观，如痘疮样胃炎，胃体和胃底有多个隆起的慢性糜烂，或表现为胃体和胃底的巨大皱襞性胃炎。这种类型的胃炎通过组织学诊断，基于胃黏膜表面细胞中上皮内淋巴细胞的聚集（超过25/100个上皮细胞）。其病因发病机制目前被认为是一种与口炎性腹泻相关的反应或对幽门螺杆菌感染的非典型反应。一些研究报告称，在几乎45%的口炎性腹泻病例中存在淋巴细胞性胃炎，胃炎在无麸质饮食后消退，而其他研究报告淋巴细胞性胃炎与血清学和/或组织学确诊的幽门螺杆菌感染相关，在高比例病例中，幽门螺杆菌根除治疗可治愈淋巴细胞性胃炎。口炎性腹泻和淋巴细胞性胃炎这两种病理实体可能都存在对炎症因子的类似异常免疫反应——在一种情况下是麸质，在另一种情况下是幽门螺杆菌——这意味着口炎性腹泻诱发型和幽门螺杆菌诱发型淋巴细胞性胃炎并存。
