Eosinophilic Gastritis: Histopathologic Characterization and Quantification of the Normal Gastric Eosinophil Content.
Shelby D Melton, Robert M Genta, Thida Lwin. VA North Texas Health Care System, Dallas; University of Texas Southwestern Medical Center, Dallas; Caris Life Sciences, Irving, TX
Background: There are no published criteria for the diagnosis of eosinophilic gastritis, and information about normal eosinophil counts in the gastric mucosa is limited. Therefore, pathologists are often uncertain as to when and how increased eosinophils in gastric biopsies should be reported. The aims of this study were: 1) to determine the normal gastric eosinophil content in histologically unremarkable gastric biopsies; and 2) to investigate the clinicopathologic features of eosinophilic gastritis.
Design: From an electronic database we extracted 60 patients (median age 50; range 4-83; 34 females) whose gastric biopsies over a 2-year period were diagnosed as having elevated mucosal eosinophils. For each study patient we then identified 2 or 3 age-, sex-, and ZIP code-matched control subjects who had unremarkable gastric biopsies during the same period. We reviewed all slides and counted eosinophils in the lamina propria in 5 high-power fields. Involvement of the muscularis mucosae or submucosa and sheets of eosinophils were noted, and infiltration of the gastric epithelium was scored on a scale of 0 to 2. Results are reported in eosinophils/mm2.
Results: Eosinophil counts from gastric biopsies of study patients and controls are listed in Table 1.
|n = 60||n = 135|
|Median density (eos/mm²)||180||6|
|Mean density (eos/mm²)||218||4.9|
|Range||4 - 665||0 - 34.6|