Gastric inverted hyperplastic polyp. Report of four cases and relation to gastritis cystica profunda
Gastric inverted hyperplastic polyp (IHP) is a rare type of gastric polyp, and is characterized by downward growth of the hyperplastic mucosal components into the submucosa. To the best of our knowledge, 16 gastric IHP cases have been described in the English literature, but the pathogenesis has not been established. We report the clinical and pathological findings of four gastric IHP cases. The lesions were mainly composed of hyperplastic foveolar-type glands with focal cystic dilatation. Pyloric type glands, endocrine cells, acinic cell metaplasia, and smooth muscle bundles were also seen as components of the polyp. Two cases (cases 1 and 4) coexisted with multifocal gastritis cystica profunda (GCP) and gastric adenocarcinoma. Case 4 furthermore exhibited an intermediate form between IHP and GCP. We suggest that IHP may be GCP associated with exaggeratedly hyperplastic and metaplastic changes. In case 4, the coexisting gastric carcinoma was mainly located in the submucosa, whilst the mucosal component was minimal. Five out of twenty reported gastric IHP cases, including our cases, coexisted with gastric adenocarcinoma. These facts would lead us to further investigate the relation between gastric IHP and carcinoma.
Document Type: Research Article
Affiliations: 1: Department of Pathology, University of Tokushima School of Medicine, Tokushima, 2: Division of Gastroenterology, Department of Internal Medicine, University of Tokushima School of Medicine, Tokushima, 3: Department of Pathology, Tokushima Civic Hospital, Tokushima, 4: Department of Surgery, University of Tokushima School of Medicine, Tokushima, 5: Department of Surgery, Awaji Prefectural Hospital, Hyogo, and 6: Department of Surgery, Oe-Kyodo Hospital, Tokushima, Japan
Publication date: 2002-10-01