Lymphocytic gastritis: Association with etiology and topology

Lymphocytic gastritis (LG) is an uncommon chronic gastritis characterized b y lymphocytosis of foveolar and surface epithelium. Lymphocytic gastritis i s associated with celiac disease, Helicobacter pylori (HP) gastritis, and v arioliform gastritis, but its topology and severity with respect to the ass ociated entities have not been studied in detail. Therefore, we studied 103 patients with LG classified according to the associated entities, includin g the distribution and severity of LG in the 70 patients from whom biopsy s pecimens of both antrum and body were available. In 84 patients (82%), a di stinct associated entity was identified, including 39 with celiac disease, 30 with HP infection, 4 with varioliform gastritis, 2 each with inflammator y polyp, Crohn's disease, human immunodeficiency virus infection, lymphoma, and esophageal carcinoma, and 1 with lymphocytic gastroenterocolitis. Lymp hocytic gastritis was found in 33% of patients with celiac disease and 4.1% of histopathologically defined HP gastritis. The severity of intraepitheli al lymphocytosis was greater in antrum than in body in 83% (20 of 24) of LG associated with celiac disease, but in only 19% (4 of 21) of LG associated with HP infection (p < 0.00002). All four patients with varioliform gastri tis had more severe involvement of body. Lymphocytic colitis was common (38 %, 5 of 13) in celiac disease with LG. Our results indicate that lymphocyti c gastritis most commonly occurs in celiac disease and HP infection, but ra refy with other entities. The topology of LG can direct the clinical evalua tion for associated disease.