Gastric
Hyperplastic Polyp
Epidemiology and Etiology:
- 75% of all gastric
polyps
- thought to be a
consequence of mucosal response to tissue injury and inflammation
- foveolar
hyperplasia à polypoid foveolar hyperplasia à
hyperplastic polyp
- conditions
predisposing to hyperplastic polyp:
- H. pylori gastritis
- Chronic gastritis
of any cause
- particularly
atrophic gastritis
- Older patients
(50s, 60s)
Common sites:
Gross features:
- small, sessile
- usually multiple
- usually < 1cm
- surface erosion
often
Histologic features:
- architecturally
distorted, irregular, cystically dilated, elongated foveolar epithelium
- corkscrew
appearance often
- often abundant
mucinous cytoplasm
- may have slightly
enlarged and hyperchromatic nuclei with prominent nucleoli (regenerative
atypia)
- pseudogoblet or
globoid mucinous cells frequently present
- apical nuclei and
basal mucous vacuoles
- lamina propria
changes
- edematous
- congested
- variable acute and
chronic inflammation
- nodular lymphoid
aggregates may be present
- smooth muscle
extending to surface often
- erosions often
- H. pylori present often (up to 76%)
- Dysplasia may be
present (same appearance as usual)
- Should extend to
the surface
Immunophenotype:
Marker:
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Sensitivity:
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Specificity:
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Molecular features:
Other features:
- may regress
after treatment of H. pylori
- risk of dysplasia
in larger polyps
References:
- Odze,
Surgical Pathology of the GI Tract 2004