Gastric Polyps

 

 

General Considerations

• Most common benign gastric tumor
• Associated with:
• Hyperacidity and ulcers
•  Chronic atrophic gastritis
• Gastric carcinoma
• Low incidence of malignant transformation

Clinical Findings

• Usually found incidentally
• Can become inflamed and eroded
• Bleeding is rare
• Large polyps near antrum can cause gastric outlet obstruction

Hyperplastic polyp (inflammatory polyp) (75-90%)

• Proliferated gastric mucosa and inflammatory cells
• Associated with pernicious anemia
• Random distribution in stomach
• Usually multiple
• Usually <1cm with no progression
• No malignant potential

Adenomatous polyp (10-20%)

• True neoplasm with very low malignant potential (<4%)
• Associated with Gardner’s syndrome, juvenile polyposis and Cronkhite-Canada syndrome
• Occurs more commonly in antrum
• Often single
• Usually>1.5cm in size
• Occurs in patients over 50 years old

Hamartomatous polyp (rare)

• Densely packed gastric glands
• Associated with Peutz-Jeghers syndrome
• Usually <2cm in diameter

Retention polyp (rare)

            • Dilated cystic glands

            • Associated with Cronkhite-Canada syndrome

Villous polyp (rare)

            • Can undergo malignant transformation

 

DDX:

            • Menetrier disease (antrum is spared)

            • Eosinophilic polyps

            • Lymphoma

            • Carcinoma

            • Pancreatic rest (antrum)