Book Review

Gastritis

N Engl J Med 2000; 342:827-828March 16, 2000

Article

Gastritis
Edited by David Y. Graham, Robert M. Genta, and Michael F. Dixon. 257 pp., illustrated. Philadelphia, Lippincott Williams & Wilkins, 1999. $165. ISBN: 0-397-51675-4

The identification of Helicobacter pylori as the cause of peptic ulcer in the early 1980s resulted in a major reappraisal of chronic gastritis. In recent years many books have been published on H. pylori and gastroduodenal disease, yet few have focused specifically on gastritis. The two eminent histopathologists, Dixon and Genta, who, in addition to Graham, edited Gastritis, have made important contributions to the reclassification and grading of gastritis and the development of the updated Sydney system for gastritis. For the nonspecialist, the book contains useful introductory chapters on the anatomy and physiology of the stomach. Part II expertly covers the classification and grading of gastritis, explaining in depth the updated Sydney system, and well-illustrated chapters detail the histologic components of gastritis in adults and children.

Part III features chapters about uncommon forms of gastritis, such as those induced by viral, fungal, and parasitic species and bacterial species other than H. pylori. A well-illustrated chapter by DeNardi and Riddell covers chemical gastritis. Acute hemorrhagic gastritis, lymphocytic gastritis, granulomatous gastritis, vascular gastropathies, and autoimmune gastritis are the subjects of other chapters. Most of these authoritative chapters by leading histopathologists are accompanied by excellent color photomicrographs, but it is disappointing that the chapters on autoimmune and lymphocytic gastritis are largely illustrated with black-and-white photomicrographs. There is also inconsistency between chapters in the provision of details on magnification and staining in the legends to the photomicrographs. Given the current interest in animal models of H. pylori infection, a chapter on comparative studies of gastritis in such models would have been a useful addition.

Parts IV and V cover the role of H. pylori in peptic ulcer disease and gastric neoplasia. These sections contain useful, detailed chapters on the diagnosis and treatment of H. pylori infection and the role of H. pylori–induced perturbations in gastric function that contribute to the pathogenesis of peptic ulceration. Surprisingly, none of the chapters address the mucosal immune response to H. pylori. Since the identification of H. pylori as the cause of chronic gastritis, there have been considerable advances in our understanding of gastric immune responses. Recent advances in molecular pathogenesis, particularly with respect to the cag pathogenicity island and epithelial-cell signaling responses, which are relevant to the etiology of chronic gastritis, are also not included. Part V, however, does contain useful chapters on the molecular basis of gastric carcinogenesis and the relation between H. pylori infection and gastric B-cell lymphoma. For those with a particular interest in the histopathology of gastritis and its classification, this book, although expensive, is a useful and well-illustrated reference source.

Jean E. Crabtree, D.Phil.
St. James University Hospital, Leeds LS9 7TF, United Kingdom