Abstract
Objective
The purpose of this study is to describe a small case series of primary gastritis cystica polyposa (GCP) and explore its imaging features, endoscopic findings, and pathological manifestations.
Methods
In this institutional review board-approved, HIPAA-compliant, retrospective study, an electronic pathology database in our hospital was searched for all cases of GCP from July 2008 to December 2015, yielding five cases with both radiological and endoscopic examination. The characteristics of imaging and gastroscopy were explored, and the pathological basis was analyzed.
Results
All five cases of GCP occurred in a previously unoperated stomach, which underwent unenhanced CT and enhanced CT, and one of which underwent unenhanced MRI and enhanced MRI as well. Gastroscopy or gastroscopic ultrasound was performed on all five patients. Four submucosal cystic lesions were displayed, including three with low-attenuation liquid, and one with high-attenuation liquid on CT. Another lesion showed soft tissue mass attenuation protruding into the gastric cavity. The surface mucosal layers of all five lesions were smooth and obviously enhanced, with unenhanced cystic component inside. Four submucosal lesions were confirmed by gastroscopy. Gastroscopic ultrasound indicated anechoic area in the center of the lesion. A large mass-like lesion had protruded into the gastric cavity, and gastroscopic ultrasound indicated dispersed anechoic areas in the lesion. All Histopathological analyses indicated mild or moderate epithelial dysplasia, and cystic dilation of the gastric glands in the submucosal layers and lamina propria, surrounded by the infiltration of inflammatory cells.
Conclusion
Primary GCP has relatively particular endoscopy features, which can be accurately diagnosed by gastroscopy when the lesion is small. But endoscopy has its limitations in the diagnosis and differentiation for some large lesions. In contrast to gastroscopy and gastroscopic ultrasound, CT or MRI provides more information about both the gastric wall and the extragastric extent of the disease, which is more helpful for differential diagnosis and surgical planning of GCP before operation.
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References
Littler ER, Gleibermann E (1972) Gastritis cystica polyposa (gastric mucosal prolapse at gastroenterostomy site, with cystic and infiltrative epithelial hyperplasia). Cancer 29(1):205–209
Franzin G, Novelli P (1981) Gastritis cystica profunda. Histopathology 5(5):535–547
Chung I, Kim E, Kim D, et al. (2001) Clinical significance of endoscopic ultrasonography in gastritis cystica polyposa. Korean J Gastrointest Endosc 22(4):195–201 ([in Korean])
Sussman HM, Weingarten B, Mossberg SM (1965) Localized gastric mucosal hypertrophy simulating tumor. Am J Digest Dis 10:710–718
Aoyagi K, Koufuji K, Yano S, et al. (2000) Two cases of cancer in the remnant stomach derived from gastritis cystic polyposa. Kurume Med J 47(3):243–248
Franzin G, Musola R, Zamboni G, et al. (1985) Gastritis cystica polyposa: a possible precancerous lesion. Tumori 71(1):13–18
Ochiai M, Matsubara T, Zhi LZ, et al. (2000) Gastritis cystica polyposa associated with a gastric stump carcinoma, with special reference to cell kinetics and p53 gene aberrations. Gastric Cancer 3(3):165–170
Kalra Vivek B, Gilbert John W, Mitchell Kisha A, Salem Ronald R, Israel Gary M (2013) AIRP best cases in radiologic-pathologic gastritis cystica polyposa. Radio Graphics 33:109–114
Wu MT, Pan HB, Lai PH, et al. (1994) CT of gastritis cystica polyposa. Abdom Imaging 19(1):8–10
Lee J, Park CM, Kim KA, et al. (2010) Cystic lesions of the gastrointestinal tract: multimodality imaging with pathologic correlations. Korean J Radiol 11(4):457–468
Levy AD, Remotti HE, Thompson WM, et al. (2003) Gastrointestinal stromal tumors: radiologic features with pathologic correlation. RadioGraphics 23(2):283–304
Park CH, Park JM, Jung CK, et al. (2009) Early gastric cancer associated with gastritis cystica polyposa in the unoperated stomach treated by endoscopic submucosal dissection. Gastrointest Endosc 69(6):e47–e50
Acknowledgments
This study was funded by Zhejiang Provincial Natural Science Foundation (Grant Number LY12H18003).
Authors contributions
Shaolin Gong: acquisition of data; analysis and interpretation of data; drafting of the Manuscript. Zhihan Wu: technical and material support. Shunliang Xu: critical revision of the manuscript for important intellectual content. Jingfeng Zhang: study concept and design; study supervision.
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Conflict of Interest
Jingfeng Zhang, Shaolin Gong, Zhihan Wu, Shunliang Xu declare that they have no conflict of interest.
Ethical approval
All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Informed consent was waived because of the study’s retrospective nature.
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Gong, S., Wu, Z., Xu, S. et al. Imaging, endoscopy, and pathologic findings of primary gastritis cystica polyposa: description of a rare entity in a small case series. Abdom Radiol 41, 2095–2101 (2016). https://doi.org/10.1007/s00261-016-0821-9
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DOI: https://doi.org/10.1007/s00261-016-0821-9