Wotherspoon et al developed a simple scale for classification of gastric lymphoid infiltrates. This can help distinguish benign, reactive processes from true MALT (mucosa-associated lymphoid tissue) lymphomas. The authors are from University College Medical School in London and Ospedale Civile in Feltre, Italy.
Features |
Description |
Grade |
scattered plasma cells in the lamina propria; no lymphoid follicles present |
normal |
0 |
small clusters of lymphocytes in the lamina propria; no lymphoid follicles present; no lymphoepithelial lesions present |
chronic active gastritis |
1 |
prominent lymphoid follicles with surrounding mantle zone and plasma cells; no lymphoepithelial lesions present |
chronic active gastritis with florid lymphoid follicle formation |
2 |
lymphoid follicles surrounded by small lymphocytes that infiltrate diffusely in the lamina propria and occasionally into the gastric epithelium |
suspicious lymphoid infiltrate in the lamina propria, probably reactive |
3 |
lymphoid follicles surrounded by centrocyte-like lymphocytes that infiltrate diffusely in the lamina propria and into the gastric epithelium in small groups |
suspicious lymphoid infiltrate in the lamina propria, probably lymphoma |
4 |
dense diffuse infiltrate of centrocyte-like lymphocytes in the lamina propria; prominent lymphoepithelial lesions present |
low grade B-cell MALT lymphoma |
5 |
where:
• A lymphoepithelial lesion is defined as unequivocal partial destruction of gastric glands or crypts by groups of centrocytic-type lymphocytes.
Purpose: To evaluate the lymphoid infiltrate in a gastric biopsy using the classification scale of Wotherspoon et al.
Specialty: Hematology Oncology, Otolaryngology, Gastroenterology
Objective: clinical diagnosis, including family history for genetics, severity, prognosis, stage
ICD-10: C88.4,