Gastric polyps Flashcards
(18 cards)
What is the definition of gastric polyps?
Mass that projects above the level of the surrounding mucosa
Usually benign epithelial elevations of the gastric lining
What is the incidence of gastric polyps?
Relatively rare – incidence ≈1%
Most common benign lesion of the stomach
What is the classification of gastric polyps based on?
Based on cell of origin
What are the types of epithelial gastric polyps? (list 5+ two conditions)
- Fundic gland polyps (46%)
- Hyperplastic
- Adenomatous (6%)
- Heterotopic
- Hamartomatous
Includes conditions like Peutz-Jeghers or Cowden’s syndrome
What is the etiology of gastric polyps?
Mostly unknown
What factor may increase the risk for fundic-gland polyps?
PPIs may increase risk due to glandular hyperplasia and decreased luminal flow
What causes hyperplastic polyps?
Due to inflammation / mucosal damage (e.g., H. pylori)
What are the clinical characteristics of gastric polyps?
Usually asymptomatic; incidental finding at 2-3% of gastroscopies
Occasionally bleed or prolapse through pylorus causing pain & vomiting
Where do fundic gland polyps occur?
Exclusively in fundus & body; sporadic & of no clinical consequence
What are familial fundic gland polyps associated with?
- FAP (APC mutation)
- Sporadic (β-catenin mutation)
Dysplasia only found in FAP associated fundic gland polyps
What is the composition of hyperplastic polyps?
Composed of epithelial and stromal components; located in antrum
What is the significance of dysplasia in hyperplastic polyps?
Up to 20% show dysplasia with mutation in p53; usually only larger polyps >2cm
What is the malignant potential of adenomatous gastric polyps?
Associated with adenocarcinoma (malignant potential 10%-20%)
What are the characteristics of intestinal type adenomatous polyps?
Pts >50yrs; M:F 3:1; precursors to gastric adenocarcinoma
What size of adenomatous polyps harbors adenocarcinoma?
50% adenoma >2cm harbor adenocarcinoma
What are the indications for biopsy or removal of a gastric polyp?
- Symptomatic
- Size >1cm
- Adenomatous
> 2cm biopsy polyp to exclude malignancy – may need gastrectomy
What is the follow-up recommendation after removal of adenomatous polyps?
Follow-up scope after removal
What are the types of malignant neoplasms of the stomach?
- Adenocarcinoma (95%)
- Lymphoma (4%)
- Carcinoid (3%)
- GIST (2%)
- Squamous
- Adenocanthoma
