Wendy Snyder HT(ASCP) at United Hospital Center in Clarksburg, West Virginia 
asks about stains for Helicobacter pylori in gastric biopsy material, and 
notes the difficulty of satisfying several pathologists' requirements. 
Several other contributors comment on the problem.

As far as I know, there has never been a published study comparing various 
methods for demonstrating Helicobacter pylori, evaluating sensitivity as well 
as histologists' and pathologists' operator time. As a locum tenens 
pathologist in numerous usually small laboratories, I would say that 
Diff-Quik (or a generic equivalent such as toluidine blue) is most common, no 
special stain at all is second most common; I have once seen IHC and twice 
seen a silver stain.

My personal opinion is that doing no stain at all is unacceptable practice. I 
suspect that Diff-Quik is as good as the more complex methods, if the 
pathologist is willing to take the time to examine the section with a 100x 
oil immersion objective lens (a point I have never seen brought out in 
print). The use of an oil immersion lens slows the pathologist down notably, 
and if I had a high volume practice and some authority over my laboratory, I 
would probably have the histotechnologist do the search for Helicobacter 
pylori, and examine bacteria only in positive specimens.

Please, folks, when you submit to this list please turn off HTML in your mail 
client, and don't repeat the previous messages. I'm not reading my Histonet 
digest regularly because of the amount of junk routinely posted with the 
messages.

Bob Richmond
Samurai Pathologist
Knoxville TN