[Histonet] Re: Demonstration of H. Pylori

[rsrichmond <@t> aol.com]

I have experience with two techniques for Helicobacter, blue dye (Diff-Quik II, Giemsa, toluidine blue), and immunohistochemistry. 
 
My experience is that the dye method often requires oil immersion examination (slightly time consuming), where IHC slides can be examined under much lower magnification. This difference doesn't matter if I have three gastric biopsies a week, but it matters a lot if I have ten in a day, plus fifty other cases to sign out.
 
Many laboratories do the stain - whatever stain they do - on every gastric biopsy specimen. Others only do the stain only if it's specifically requested, or if neutrophilic infiltration (chronic active gastritis) is seen in the H & E sections.
 
A current discussion going on on PATHO-L suggests that regulators are starting to prohibit doing IHC on every gastric biopsy specimen, and you should be following this point closely.
 
I've often been told that real men can see Helicobacter in the H & E slides, but I can't reliably - maybe it's my 68 year old eyes.
 
It's simpler to a quick stain with Diff-Quik II (or one of its generic equivalents) or with toluidine blue, rather than doing a full Giemsa stain.
 
A frequently ought-to-be-asked question: does Helicobacter heilmannii (the bug formerly known as Gastrospirillum hominis) mark with the H. pylori antibody? Answer (according to Japanese sources - H. heilmannii is more common in Japan than in the rest of the world) is that it definitely does mark. (I've seen H. heilmannii once in my life, and that was good many years ago.)
 
Bob Richmond
Samurai Pathologist
Knoxville TN
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