We do three levels on all gastric biopsies, with one extra unstained slide
at each level.

We do Diff Quik on the gastric biopsies that come down with the a pre-biopsy
"diagnosis" of ulcer (equivalent of "rule out ulcer/H. pylorii"). An
additional extra slide at the 2nd level is cut for this stain. (this still
leaves one unstained at the 2nd level, just in case. . . )

If the r/o is for cancer or any other diagnosis besides the ulcer, we still
cut 3 levels H&E with one extra unstained at each level, but do not do the
Diff Quik.

If the pathologist, upon seeing the H&E of a case that did not have the "r/o
ulcer", sees something that suggests ulcer, they can come back and ask us to
do the Diff Quik on one of the extra unstained slides from the levels.

If the Diff Quik does not demonstrate H. pylori, and the pathologist is
still convinced that the patient must have it, we use one of the extra
unstained slides to do a Steiner and Steiner.

Once is a great while, the St & St does not demonstrate H. pylorii, and it
the pathologist still suspects ulcer, so the pathologist requests IHC to be
done on another additional unstained slide.

Yes, H. pylorii does seem to skip around, and is not necessarily seen at all
levels.

Hope this helps.

Peggy A. Wenk, HTL(ASCP)SLS
William Beaumont Hospital
Royal Oak, MI 48073


----- Original Message -----
From: 
To: ; 
Sent: Thursday, October 24, 2002 1:27 PM
Subject: H pylori and special stains


> Hi all,
>     Does your lab automatically perform special stains for H pylori on all
> gastric biopsy material as a matter of routine or do you wait and perform
> them at the discretion of the pathologist after the H&E-stained sections
have
> been seen?  Has anyone had experience with seeking an annual 'standing
order'
> from gastroenterologist groups desiring these special stains on all
gastric
> biopsies?
> Thanks,
> K Whittenburg
>