Lymphocytic Gastritis: A Case Series Highlighting the Clinical, Histopathologic, and Endoscopic Findings: 1255

Introduction: Lymphocytic gastritis (LG) is an uncommon histopathologic condition found on less than 1% of endoscopies. It is a subtype of microscopic gastritis and is defined as 25 lymphocytes per 100 gastric epithelial cells infiltrating the surface epithelium. It is classified as either secondary LG, [most commonly associated with celiac disease (CD) or H pylori gastritis (HPG)], or idiopathic LG. This study will aim to identify demographics, clinical presentations, concomitant gastrointestinal conditions, as well as histopathologic and endoscopic findings in patients with LG. Methods: A retrospective chart review was performed of all patients with the diagnosis of LG based on pathology reports from 1/1/2000 to 12/1/2014 at a single tertiary care center. The medical records of each of these patients were reviewed for data including demographic information, presenting symptoms, indications for endoscopy, endoscopic findings, histologic findings, and comorbid diseases. Results: 30 patients with biopsy proven LG were identified. The mean age of patients with LG was 56. 60% of patients were male and 40% were female. The mean BMI was 26. The most common signs and symptoms identified included abdominal pain (23.3%), diarrhea (20%), and anemia (16.6%)(Table 1). 23.3% of patients were asymptomatic at the time of presentation. Aside from meeting the other criteria as described for LG, the most common histologic findings were duodenal intraepithelial lymphocytosis (52.9%) and villous blunting (52.9%). The most common endoscopic findings were erythema (40%) and erosions (16.6%)(Table 2). 5 patients with LG also had CD, 1 patient had HPG, and 3 patients had lymphocytic colitis.Table: Table. Presenting Signs and Symptoms in Lymphocytic GastritisTable: Table. Histologic and Endoscopic Findings in Lymphocytic GastritisConclusion: Our case series reinforces that LG has a variable clinical and endoscopic presentation. The diagnosis of LG remains highly dependent on the histopathological interpretation of endoscopic biopsies. Based on the association between LG and certain conditions, patients with LG should be fully evaluated for associated diseases such as CD and HPG before being labeled as having idiopathic LG. Future studies should be aimed at further defining the role of endoscopic monitoring and identifying possible treatments for patients with LG.