Histologic Classification of Gastric Polyps

Abstract

In all papers dealing with polyps of the gastro-intestinal tract the term polyp is defined in the introductory remarks. Mucosal prominences of different size and shape are called polyps. Therefore this word can only be used as a preliminary clinical “working diagnosis.” When Morson (1972) complains that the uncritical use of the term polyp is the cause of our poor knowledge of benign neoplasias of the stomach, this is due to the fact that even pathologists use the word polyp as a diagnostic term or at least as part of one. The histologic findings often remain subordinate as descriptive adjectives. This misinterpretation can be counteracted if the histologic structure and the pathogenesis are the basis for the nomenclature of gastric polyps. This is not new because it corresponds with Morson’s (1962) criteria for the histologic classification of colonic polyps. Actually in making histologic classifications this analogous thinking may lead to uncertainty (Elster, 1974). Gastric polyps have a different histogenesis compared with large bowel polyps so that one cannot expect mucosal polyps in the stomach to grow the same way as in the colon. Neglect of this fact has, in my opinion, not only led to confusion in terminology but also to clinical misinterpretation (Monaco et al., 1962; Nakamura, 1970; Jansen, 1974; Nagayo, 1975).