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Pathology

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The pathogenesis of H. pylori-associated gastritis is characterised by:

  • predominant involvement of the antrum
  • characterised by presence of markers of chronic (mononuclear cells) and active (neutrophils) inflammation
  • intestinal metaplasia and atrophy:
    • predominantly in the antrum and corpus
    • as atrophy of the corpus progresses the gastric acid secretion reduces and the patient may become less symptomatic from any ulcer disease
    • the hypochlorhydric state is a risk factor for the development of gastric cancer
  • development of lymphatic tissue:
    • the normal gastric mucosa contains no lymphatic tissue - patients with chronci H. pylori infection have mucosa-associated lymphatic tissue.
    • there is evidence linking H. pylori gastritis with gastric lymphoma.

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