report of a gastric polyp should comment on the following:
- Biopsy or excision specimen
- Histological features of the polyp:
- Presence of cystic dilatation
- Lining epithelium of the cyst
- Presence of muscle fibres in the lamina propria.
- Inflammatory inflltrate (
Example: presence of eosinophils. )
- Mention the type of polyp - (Neoplastic or non-neoplastic)
- Presence or absence of dysplasia or malignancy.
- Finally comment on whether the excision is complete. (Not possible
in a small biopsy )
is applied to any nodule or mass that projects above the level of the
Gastric polyps are rare and are found in 0.4% of adult autopsies and
3-5% of Japanese adults.
1) Regenerative (hyperplastic)
2) Hamartomatous (Example: Peutz- Jeghers, juvenile polyp )
3) Neoplastic (adenomatous polyp).
Some neoplastic lesions present as
epithelial polyps (first part).
epithelial polyps (part two).
Non-neoplastic lesion presenting as as
a gastric polyp - Inflammatory
Well circumscribed small sessile or peduculated lesion.
Blood vessels surrounded by spindle cells (CD34 positive) and chronic
inflammatory cells (mainly eosinophils). Multinucleated giant cells
may be present.
Eosinophilic gastritis (diffusely thickened , deformed antrum,
eosinophils in peripheral blood).
Eosinophilic granuloma (parasitic infection).
Inflammatory Fibroid Polyp of the Esophagus:
Inflammatory fibroid polyp of the stomach: a
to an immunohistochemical profile of 42 cases.
CD34 expression by inflammatory fibroid polyps of
Gastritis Cystica Polyposa:
At the site of gastroenterostomy stoma.
Multiple sessile polyp around the
Resemble hyperplastic polyp.Cystically
dilated glands extend through the muscularis mucosae into the
Intestinal metaplasia may be present. No evidence of any
May be associated with development of gastric stump carcinoma.
cystica polyposa: report of 7 cases and literature review.
-Pathologic features and mucin histochemistry of primary gastric stump
carcinoma associated with
gastritis cystica polyposa: a study of six cases.
Common in patients treated with proton pump inhibitors.
May also occur
in patients with familial adenomatous polyposis.
These are not premalignant lesions.
Body and fundus.
Multiple transparent, sessile polyps usually less than 1cm in
Cystically dilated glands lined by
gastric body type mucosa.
Irregular shortened foveolae, smooth muscle fibres around the dilated
Hypertrophy and hyperplasia
of parietal cells in patients treated with proton pump inhibitors.
cell hyperplasia with structural and nuclear atypia: a variant of
fundic gland polyp.
-Gastric fundic polyps:
a morphology study using mucin histochemistry, stereometry and MIB1
fundic gland polyps: an immunohistochemical study of their antigenic
-The histopathology of fundic gland polyps of the
Most common type of gastric polyp.
(Type I and II).
Polyp formation related to:
-Helicobacter - associated gastritis.
-Adjacent to ulcers and erosions.
Gross: Sessile or pedunculated.
Less than 2 cm in diameter.
Type I : Solitary . In the antrum.
Type II : Multiple. In distal fundic mucosa (junction of body and
Central dimple noted in
Elongated, tortuous glands, irregular branching.
Glands lined by hyperplastic foveolar-type epithelium.
Cystic changes may be present.
Other features: Smooth muscle fibres present in lamina propria.
; Stroma edematous and inflamed. ; Pseudo-invasion may be present.
In Type II hyperplastic polyp, superficial glands show onion-skin
Why is the hyperplastic polyp a marker for the
precancerous condition of the gastric mucosa?
Cardiac glands hyperplastic
polyp of the stomach.
A case of gastric hyperplastic
polyp with malignant transformation.
Rare in stomach.
Peutz Jeghers polyp:
Hyperplastic glands lined by foveolar
epithelium. Broad bands of smooth muscle fibres branch out.
Juvenile polyp: Antrum. May be associated with juvenile
polyposis. Histologically, the glands are tortuous, elongated, and
cystically dilated . Backround mucosa is edematous and inflamed.
Polyps in Cronkhite Canada syndrome:
(associated with nail atrophy,
alopecia or hyperpigmentation)
Polyps in Cowden's disease: Elongated cystically dilated glands
with papillary infoldings.
Connective tissue component - neural or muscular.
as a mass in the pylorus or antrum.
Central depression noted on the mucosal
Histological feature :
Normal pancreatic acini and ducts are noted.
(acinar) metaplasia of the gastric mucosa.
ultrastructure, immunocytochemistry, and clinicopathologic
correlations of 101 cases.