Is there a consensus on the number of chronic inflammatory cells in normal patients?
A. The question asks about the minimum number of mononuclear cells needed to call a gastric biopsy abnormal, but because of similar queries regarding minimal criteria for abnormality in other GI sites, this response is generalized. The issue of abnormal inflammation in glandular GI tract mucosa can be divided into a three-part algorithm based on qualitative and quantitative assessments: • Qualitative assessment: Any neutrophils, increased eosinophils or abnormal histiocytes (either foamy or clustered) are abnormal. Neutrophils will normally be noted traversing capillaries or larger vessels within the lamina propria but none should be seen within the lamina propria stroma or epithelial compartment. It is exceptional to have pathological neutrophil infiltrates within the lamina propria without also noting them in the epithelium, making the observation of intraepithelial neutrophils a sensitive and specific marker for an acute inflammatory state. Eosinophils are normally present in small
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