Benign Tumors and Polyps
Only a few types of benign polyps occur in the stomach. The main polyps encountered routinely in gastric biopsies are the fundic gland polyp and the hyperplastic polyp, which are composed mainly of oxyntic glands and elongated foveolae/pits, respectively. These polyps rarely harbor epithelial dysplasia and, even when they do, the connection of such dysplasia with gastric cancer is controversial. Some gastric polyps are associated with underlying polyposis syndromes. These include fundic gland polyps with a higher frequency of dysplasia, which occur in the setting of familial adenomatous polyposis. Most other syndromic gastric polyps strongly resemble (and can be indistinguishable from) gastric hyperplastic polyps, including those occurring in Peutz–Jeghers syndrome, juvenile polyposis, and others. Thus, it is important to keep these syndromes in the differential diagnosis when encountering numerous or recurrent benign gastric polyps in any given patient. Lastly, the “inflammatory fibroid polyp” (IFP), actually a submucosal fibroinflammatory proliferation, can appear like a polyp endoscopically and may make an appearance in gastric biopsies.