Gastric and duodenal mucosa in “healthy” individuals. An endoscopic and histopathological study of 50 volunteers

SUMMARY The results of histological and immunohistochemical examination of gastric and duo-denal biopsy specimens from 50 volunteers without a clinical history of gastrointestinal disease are reported. Multiple specimens of tissue from standard sites in the stomach and duodenum were carefully orientated, and serially sectioned for examination by light microscopy and for immuno-histochemical characterisation of plasma cells within the lamina propria. The antrum and fundus were normal in 32 of the 50 subjects but the other 18 showed histo-pathological evidence of gastritis in either the antrum or fundus. The latter appeared to be age-related. There was considerable variation in the appearance of the surface epithelium of the duodenum within as well as among individual subjects. Superficial gastric metaplasia in one or more biopsy specimens from the duodenal bulb was found in 64 % of individuals. Histopathological examina-tion of the duodenum revealed signs of chronic inflammation in 12 % of the subjects. In two individ-uals there was active inflammation but in only one of these was the diagnosis made on endoscopic appearances. Histological criteria important for the diagnosis of duodenitis are discussed. The number of plasma cells in different biopsy specimens from subjects not showing histological signs of inflammation was variable. The ratio IgA:IgG:IgM producing plasma cells was remarkably constant from subject to subject as well as from specimen to specimen. The advent of fibreoptic endoscopy in recent years has enormously extended the diagnostic possibilities in gastroenterology. Endoscopic appearances may be valuable in diagnosis but more accurate and detailed information results from histological ex-amination of mucosal biopsy specimens. In severa