Gastric Polyps & Thickened Gastric Folds



Gastric Polyps & Thickened Gastric Folds





DEFINITIONS:



  • Gastric Polyp: any abnormal growth or epithelial tissue arising from the otherwise smooth surface of the stomach Sessile or pedunculated polyps:



    • Hyperplastic: 70-90% of gastric polyps, hyperplastic, elongated glands with abundant edematous stroma; Benign


    • Adenomatous: neoplastic growths composed of dysplastic epithelium, not normally present in stomach; Pre-malignant


    • Fundic gland: hypertrophied fundic gland mucosa, normal variant; found throughout fundus and body, Benign


    • Hamartomatous: branching bands of smooth muscle surrounded by glandular epithelium, Benign


    • Early gastric cancer


  • Thickened Gastric Folds: folds appearing larger than normal and do not flatten with insufflation of air during endoscopy



    • (Radiographically, folds >10 mm in width after distention of the stomach with contrast during UGIS)


EPIDEMIOLOGY: GASTRIC POLYPS



  • Risk of cancer (malignant transformation) with gastric polyps:



    • Hyperplastic (70-90% of polyps): very low 0.6-4.5% transformation; Most common gastric polyp seen in FAP, Gardner’s syndrome


    • Adenomas: true neoplasms, as high as 75% malignant transformation, >2 cm is critically significant and need removal


    • Fundic gland: generally benign, rare cases of malignant transformation reported in large polyps associated with FAP syndromes


    • Hamartomas: thought to have no malignant potential; Most common polyp seen in Peutz-Jeghers, Juvenile polyposis syndromes


ETIOLOGIES: GASTRIC POLYPS



  • Gastric adenomatous and hyperplastic polyps: commonly appear in background of chronic gastritis Type A and H. Pylori



    • Adenomatous polyps need removal, usually accomplished endoscopically but >2 cm may need surgical resection


ETIOLOGIES:

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Aug 24, 2016 | Posted by in GASTROENTEROLOGY | Comments Off on Gastric Polyps & Thickened Gastric Folds

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