Gastric polyps

D3. Dich, J., Paaby, H., and Schwartz, M., Protein-secreting tumour of the stomach Severe hypoproteinaemia cured by removal of gastric polyp, Brit. Med. J. II, 686-688 (1961). 

Severe hypoproteinaemia cured by removal of gastric polyp. Brit. Med. ]. II, 686-688 (1961). 

Gastric polyps have been observed in a number of patients, but they disappear spontaneously during followup (SEDA-18,373). Most or all patients taking omeprazole have a non-pathological pseudohypertrophy of the parietal cells. 

An uncontrolled retrospective study of patients who had taken proton pump inhibitors for an average of 33 months found gastric polyps in 17 of 231 patients who underwent two or more endoscopies for complicated gastro-esophageal reflux disease (33). The polyps were generally small (under 1 cm), sessile, and multiple, and were present in the proximal or mid gastric body. Of the 15 polyps removed endoscopically, nine were fundic gland type, four were hyperplastic, and two were inflammatory. None had any dysplasia or carcinoma. 

Choudhry U, Boyce HW Jr, Coppola D. Proton pump inhibitor-associated gastric polyps a retrospective analysis of their frequency, and endoscopic, histologic, and ultra-structural characteristics. Am J Clin Pathol 1998 110(5) 615-21. 

Fig. 3.18. a Juvenile polyposis gastric polyps in a patient with peroral mucositis (Courtesy of Dr. Carlo Buonomo, Boston, MA, USA), b Gastritis/duodenitis in an 8-year-old eventually diagnosed with Crohn disease... 

Gastric polyps and nodules can be seen in children receiving long-term omeprazole therapy. Pashankar and Israel (2002) suggested in their study of 31 pediatric patients that there is an association rather than a coincidental relationship between these two entities. 

Other gastric polyps in children include inflammatory fibroid polyp, solitary hyperplastic polyp and polypoid focal foveolar hyperplasia (Teele and Share 2000). 

A prospective study of 1780 consecutive upper gastrointestinal endoscopies showed a prevalence of gastric polyps of 7.2% ( = 129) within this subgroup, 77 patients (4.3%) had fundic gland polyps [77. Proton pump inhibitors had been used by 64% of patients with fundic polyps and 16% of those without polyps. Multiple regression analysis showed that three... 

Hongo M, Fujimoto K, Gastric Polyps Study Group. Incidence and risk factor of fundic gland polyp and hyperplastic polyp in long-term proton pump inhibitor therapy a prospective study in Japan. J Gastroenterol 2010 45 618-24. 

Fig. 2.8a,b. Gastric Polyps. Double Contrast barium study (a) and Endoscopy (b) demonstrating innumerable benign hyperplastic polyps in the body and antrum of the stomach... 

Gastric polyps are mainly small and an incidental finding, although large ones may prolapse and cause retention-like symptoms. They are divided into non-neoplastic (Fig. 3.31) and neoplastic (Fig. 3.32). Of the former 85% are glandular cysts and hyperplastic polyps, the rest inflammatory fibroid polyps and hamartomas. 

Neoplastic polyps are epithelial in 90% of cases, the rest being endocrine, mainly carcinoid lesions. About 7% of all gastric polyps are frankly malignant according to a large series of 4,852 patients with gastric polyps (Stolte et al. 1994). 

Gastric carcinoids are small lesions and represent less than 2% of all gastric polyps. They are usually multiple and flat, sometimes with an ulcer. At endoscopy they cannot be differentiated from other polyps. 

Fig. 3.30. Metaplastic gastric polyps, which as here usually present in large numbers...

Stolte M, Sticht T, Eidt S et al (1994) Frequency, location, and age and sex distribution of various types of gastric polyps. Endoscopy 26 659-665... 

Fig. 5.18a,b. Multiple gastric polyps a Double-contrast barium meal showing multiple filling defects in the stomach due to hyperplastic polyps and (b) endoscopic view of hyperplastic polyps in a different patient... 

Gastrointest Radiol 1(2) 157-161 Miettinen M, El-Rifai W et al (2002) Evaluation of malignancy and prognosis of gastrointestinal stromal tumors a review. Hum Pathol 33(5) 478-483 Ming SC (1976) II. Malignant potential of gastric polyps. 

Tomasulo J (1971) Gastric polyps. Histologic types and their relationship to gastric carcinoma. Cancer 27(6) 1346-1355... 

Small gastric polyps are rarely seen at CT, but an exception is the distinctive lipoma shown by its characteristic appearance of a well-defined mass of fat attenuation (Fig. 6.1.7). 

Hyperplastic polyps account for 75-90% of all gastric polyps (Feczko et al. 1985). Hyperplastic polyps are often seen in the setting of chronic gastritis, atrophic gastritis or bile reflux gastritis. Although... 

On multislice CT, most hyperplastic gastric polyps are smooth, sessile, round, or oval lesions, ranging from 5 to 10 mm in size. They occur usually as multiple lesions of similar size, clustered in the gastric body or fundus on the posterior gastric wall (Fig. 6.2.18a). 

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