Gastric Polyps and Dysplasias

Abstract

Gastric polyps can be defined as luminal lesions projecting above the mucosal surface. Gastric polyps are detected in 2–3% of upper gastrointestinal endoscopies. Gastric polyps are generally divided into nonneoplastic and neoplastic types. About 80–90% of gastric polyps are nonneoplastic. Hyperplastic polyps, fundic gland polyps, inflammatory fibroid polyps, and hamartomatous polyps are nonneoplastic. Hyperplastic polyps may be sessile or pedunculated. Larger hyperplastic polyps may have small erosions or ulcerations on the surface. Fundic gland polyps appear usually as multiple, glassy, transparent, sessile polyps. Inflammatory fibroid polyps are well-circumscribed solitary, small sessile, or pedunculated lesions with regular pit pattern. Hamartomatous polyps are usually pedunculated, round polyps with hyperemic and exudative surfaces. Dysplastic epithelium is defined as noninvasive, neoplastic epithelium. Gastric adenomas are defined as circumscribed, polypoid dysplastic lesions. Flat tubular adenomas are also called dysplasias. Endoscopically, adenomas/dysplasias are reddish or whitish discolored, often with a multilobulated surface, contrasting with smooth and atrophic adjacent mucosa. The surface may be smooth or superficially eroded.