Elsevier

Human Pathology

Volume 29, Issue 8, August 1998, Pages 784-790
Human Pathology

Original contribution
Low prevalence of monoclonal b cells in Helicobacter pylori gastritis patients with duodenal ulcer,☆☆

https://doi.org/10.1016/S0046-8177(98)90446-4Get rights and content

Abstract

We have studied the prevalence of B-cell clonality among a large group of 320 patients with Helicobacter pylori gastritis and duodenal ulcer. These patients underwent endoscopic examination with multiple gastric biopsies at diagnosis and were followed 2 and 12 months after therapy. Histopathologic examination of 809 sets of biopsy specimens showed lymphoid gastritis with lymphoid aggregates or follicles, but without lymphoepithelial lesion, in 302 samples corresponding to initial biopsy specimens (n = 130) or to posttreatment biopsy specimens (n = 172). DNA extracted from fresh antral specimens allowed the amplification of Helicobacter pylori DNA in all cases before therapy. The arrangement of the immunoglobulin heavy chain gene was studied by polymerase chain reaction (PCR) in the 302 selected lymphoid gastritis samples. Single or dominant bands were seen only in four specimens from three patients (1.3%), whereas a polyclonal pattern was seen in the other 298 samples. The detection threshold of our PCR technique was approximately 3% of clonal B cells diluted in a polyclonal population. This threshold appeared to be a reliable cutoff between polyclonal gastritis and clonal MALT lymphoma. In our experience, Helicobacter pylori lymphoid gastritis appeared mainly as a benign polyclonal condition.

References (41)

  • E Freeman et al.

    Occurence and prognosis of extranodal lymphomas

    Cancer

    (1972)
  • D Owen

    Normal histology of the stomach

    Am J Surg Pathol

    (1986)
  • M Stolte et al.

    Lymphoid follicles in antral mucosa: Immune response to Campylobacter pylori

    J Clin Pathol

    (1989)
  • J Wyatt et al.

    Immune response of the gastric mucosa to Campylobacter pylori

    Scand J Gastroenterol

    (1988)
  • S Eidt et al.

    Helicobacter pylori gastritis and primary gastric non-Hodgkin's lymphomas

    J Clin Pathol

    (1994)
  • E Hsi et al.

    Analysis of immunoglobulin heavy chain gene rearrangement in myoepithelial sialadenitis by polymerase chain reaction

    Mod Pathol

    (1994)
  • D Sorrentino et al.

    B-cell clonality and infection with Helicobacter pylori: Implications for development of gastric lymphoma

    Gut

    (1996)
  • M Soni et al.

    Detection of clonality in B-cell proliferations in Helicobacter pylori induced chronic gastritis in pediatric patients

    Mod Pathol

    (1997)
  • H Peng et al.

    Genetic evidence for a clonal link between low and high-grade components in gastric MALT B-cell lymphoma

    Histopathology

    (1997)
  • RJ Calvert et al.

    The significance of B-cell clonality in gastric lymphoid infiltrates

    J Pathol

    (1996)
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      However, the absence of these factors does not necessarily exclude the diagnosis of lymphoma.88, 89 Because lymphoma represents a clonal outgrowth of cells that have acquired certain genetic alterations, finding a monoclonal B-cell population might provide support for a diagnosis.20-2295-98 A monoclonal population can be revealed by genotype investigations of MALT lymphomas that use the Southern blot or polymerase chain reaction (PCR) technique.

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      Although most of these studies have focused on the sensitivity of PCR-based methods for assessment of clonality, only a few reports have addressed issues relating to its specificity in a systematic fashion. Nevertheless, some studies have demonstrated instances of false positivity, particularly when small or microdissected specimens are used,18 and in reactive conditions involving extranodal sites such as the stomach and salivary gland.19, 20 The results of our study clearly show a relationship between a paucity of B cell targets and a tendency for generating pseudomonoclonal or pseudo-oligoclonal bands by IgH PCR.

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    Supported by grants from the Délégation a la Recherche Clinique (CHU de Bordeax) and the Region Aquitaine.

    ☆☆

    Presented in part at the 86th Annual Meeting of the United States and Canadian Academy of Pathology, Orlando, FL, March 1997.

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