Granulomatous gastritis and Helicobacter pylori infection.

the antrum and lower gastric body. Antral biopsy specimens revealed multiple nonnecrotizing (sarcoid-like) granulomas [Figure] including multinucleated giant cells and histiocytes associated with moderate chronic inflammation. Helicobacter pylori was identified by rapid urease test and histology. Stains for acid-fast bacilli and fungi were negative and there was no evidence of particulate foreign material. A diagnosis of granulomatous gastritis was established. A subsequent extensive workup included: enhanced thoracic and abdominal computed tomography, CT enterography, gallium-67 scanning, protein electrophoresis and immunoelectrophoresis, and measurements of angiotensin-converting enzyme and calcium, C3-C4, anti-mitochondrial antibodies, perinuclear anti-neutrophil cytoplasmic g ranulomatous gastritis is an uncommon disease characterized by the presence of granulomas within the gastric mucosa [1,2]. Gastric granulomas may be associated with several types of infections, inflammatory and neoplastic diseases; however, Crohn’s disease, sarcoidosis and Helicobacter pylori infection should be considered first when dealing with these incidental histological findings in a western population [1-3]. We describe a case of GG without any clear etiology after a comprehensive diagnostic workup that resolved completely with H. pylori eradication therapy.