In chronic follicular gastritis the lymphoid follicles are usually localised in the lamina propria.¹ In lymphoid hyperplasia associated with a chronic peptic ulcer, numerous lymphoid follicles are sometimes present in the ulcer base, in which the muscularis propria has usually been destroyed and replaced by scar tissue.² The histology of Helicobacter-associated chronic gastritis with numerous reactive lymphoid follicles and an indistinct poorly developed marginal zone may closely simulate lymphoma and pose a diagnostic challenge. We present an extreme example of florid follicular gastritis, which mimicked a malignant neoplasm clinically and pathologically. To our knowledge, such florid hyperplasia with reactive lymphoid follicles extending into the muscularis propria and beyond has never been reported.

A 65-year-old man presented with intermittent abdominal hunger pain for one month. Endoscopic biopsies revealed …