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Gastric Hyperplastic Polyps: A Review

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Abstract

Hyperplastic polyps represent the commonest polyp encountered in the stomach. They occur in patients of either gender and are commoner in the seventh decade of life. They are usually asymptomatic, small (less than 1 cm in diameter), solitary lesions occurring in the antrum but can present with dyspepsia, heartburn, abdominal pain, or upper gastrointestinal (GI) bleeding leading to anemia. Hyperplastic polyps almost never occur in normal gastric mucosa and are most commonly associated with chronic gastritis (Helicobacter pylori or autoimmune-induced). Pathologically, they are characterized by dilated, tortuous gastric foveoli set within an inflamed, edematous stroma. There is considerable histologic overlap especially with Ménétrier’s disease and hamartomatous (juvenile or retention) polyps, and clinical input is mandatory to accomplish separation of these entities. Hyperplastic polyps arise as a by-product of repair to damaged mucosa. Dysplasia and malignancy are rarely associated with these polyps, which show an array of molecular aberrations. The importance of hyperplastic polyps for both gastroenterologist and pathologist lies in their association with other gastric mucosal pathology and mandates biopsy of adjacent mucosa and diligent search for accompanying pathology by the pathologist.

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References

  1. Abraham SC, Singh VK, Yardley JH, Wu T. Hyperplastic polyps of the stomach: associations with histologic patterns of gastritis and gastric atrophy. Am J Surg Pathol. 2001;25:500–507. doi:10.1097/00000478-200104000-00010.

    Article  PubMed  CAS  Google Scholar 

  2. Morais DJ, Yamanaka A, Zeitune JMR, Andreollo NA. Gastric polyps: A retrospective analysis of 26, 000 digestive endoscopies. Arq Gastroenterol. 2007;44:14–17. doi:10.1590/S0004-28032007000100004.

    Article  PubMed  Google Scholar 

  3. Sanna CM, Loriga P, Dessi E, et al. Hyperplastic polyp of the stomach simulating hypertrophic pyloric stenosis. J Pediatr Gastrenterol Nutr. 1991;13:204–208.

    CAS  Google Scholar 

  4. Yao T, Kajiwara M, Kuroiwa S, et al. Malignant transformation of gastric hyperplastic polyps: Alteration of phenotypes, proliferative activity, and p53 expression. Hum Pathol. 2002;33:1016–1022.

    Article  PubMed  CAS  Google Scholar 

  5. Murakami K, Mitomi H, Yamashita K, Tanabe S, Saigenji K, Okayasu I. p53, but not c-Ki-ras, mutation and down-regulation of p21WAF1/CIP1 and cyclin D1 are associated with malignant transformation in gastric hyperplastic polyps. Am J Clin Pathol. 2001;115:224–234.

    Article  PubMed  CAS  Google Scholar 

  6. Al-Haddad M, Ward EM, Bouras EP, Raimondo M. Hyperplastic polyps of the gastric antrum in patients with gastrointestinal blood loss. Dig Dis Sci. 2007;52:105–109.

    Article  PubMed  Google Scholar 

  7. Gencosmanoglu R, Sen-Oran E, Kurtkaya-Yapicier O, Tozun N. Antral hyperplastic polyp causing intermittent gastric outlet obstruction: Case report. BMC Gastroenterol. 2003; 27;3:16 http://www.biomedcentral.com/1471-230X/3/16.

  8. Abraham SC. Gastric polyps: Classification and meaning. Pathol Case Rev. 2002;7:2–11.

    Article  Google Scholar 

  9. Burke AP, Sobin LH. The pathology of Cronkhite-Canada polyps: A comparison to juvenile polyposis. Am J Surg Pathol. 1989;13:940–946.

    Article  PubMed  CAS  Google Scholar 

  10. Stolte M, Bethke B, Sticht T, Burkhard U. Differentiation of focal foveolar hyperplasia from hyperplastic polyps in gastric biopsy material. Path Res Pract. 1995;191:1198–1202.

    PubMed  CAS  Google Scholar 

  11. Rubio CA, Ost A, Kato Y, Yanagisawa A, Rivera F, Hirota T. Hyperplastic foveolar gastropathies and hyperplastic foveolar gastritis. APMIS. 1997;105:784–792.

    Article  PubMed  CAS  Google Scholar 

  12. Orlowska J, Jarasz D, Pachlewski J, Butruk E. Malignant transformation of benign epithelial gastric polyps. Am J Gastroenterol. 1995;90:2152–2159.

    PubMed  CAS  Google Scholar 

  13. Ji F, Wang Z, Ning J, Wang Q, Chen J, Li Y. Effect of drug treatment on hyperplastic gastric polyps infected with Helicobacter pylori: A randomized, controlled trial. World J Gastroenterol. 2006;12:1770–1773.

    PubMed  Google Scholar 

  14. Bamba H, Ota S, Arai S, et al. Expression of cyclooxygenase-2 in human hyperplastic gastric polyps. J Exp Clin Cancer Res. 2003;22:425–430.

    PubMed  CAS  Google Scholar 

  15. Nakajima A, Matsuhashi N, Yazaki Y, Oka T, Sugano K. Details of hyperplastic polyps of the stomach shrinking after anti-Helicobacter pylori therapy. J Gastroenterol. 2000;35:372–375.

    Article  PubMed  CAS  Google Scholar 

  16. Kume K, Hirakoba M, Murata I, Yoshikawa I, Otsuki M. Disappearance of both MALT lymphoma and hyperplastic polyps in the stomach after eradication of Helicobacter pylori. Am J Gastroenterol. 2001;96:2796–2797.

    Article  PubMed  CAS  Google Scholar 

  17. Tanaka J, Fujimoto K, Iwakiri R, et al. Hyperplastic polyps following treatment of acute gastric ulcers. Intern Med. 1994;33:366–368.

    Article  PubMed  CAS  Google Scholar 

  18. Niv Y, Delpre G, Sperber AD, Sandbank J, Zirkin H. Hyperplastic gastric polyposis, hypergastrinaemia and colorectal neoplasia: A description of four cases. Eur J Gastroenterol Hepatol. 2003;15:1361–1366.

    Article  PubMed  Google Scholar 

  19. Amaro R, Neff GW, Karnam US, Tzakis AG, Raskin JB. Acquired hyperplastic gastric polyps in solid organ transplant patients. Am J Gastroenterol. 2002;97:2220–2224.

    Article  PubMed  Google Scholar 

  20. Jewell KD, Toweill DL, Swanson PE, Upton MP, Yeh MM. Gastric hyperplastic polyps in post transplant patients: A clinicopathologic study. Mod Pathol. 2008;21:1108–1112.

    Article  PubMed  Google Scholar 

  21. Daibo M, Itabashi M, Hirota T. Malignant transformation of gastric hyperplastic polyps. Am J Gastroenterol. 1987;82:1016–1025.

    PubMed  CAS  Google Scholar 

  22. Nogueira AMMF, Carneiro F, Seruca R, et al. Microsatellite instability in hyperplastic and adenomatous polyps of the stomach. Cancer. 1999;86:1649–1656.

    Article  PubMed  CAS  Google Scholar 

  23. Hattori T. Morphological range of hyperplastic polyps and carcinomas arising in hyperplastic polyps of the stomach. J Clin Pathol. 1985;38:622–630.

    Article  PubMed  CAS  Google Scholar 

  24. Zea-Iriarte WL, Sekine I, Itsuno M, et al. Carcinoma in gastric hyperplastic polyps: A phenotypic study. Dig Dis Sci. 1996;41:377–386.

    Article  PubMed  CAS  Google Scholar 

  25. Dirschmid K, Platz-Baudin C, Stolte M. Why is the hyperplastic polyp a marker for the precancerous condition of the gastric mucosa? Virchows Arch. 2006;448:80–84.

    Article  PubMed  Google Scholar 

  26. Hirano H, Yoshida T, Yoshimura H, et al. Poorly differentiated adenocarcinoma with signet-ring cell carcinoma in a hyperplastic polyp of the stomach: Report of a case. Surg Today. 2007;37:901–904.

    Article  PubMed  Google Scholar 

  27. Hirasaki S, Suzuki S, Kanzaki H, Fujita K, Matsumura S, Matsumoto E. Minute signet ring cell carcinoma occurring in gastric hyperplastic polyp. World J Gastroenterol. 2007;13:5779–5780.

    PubMed  Google Scholar 

  28. Wu CH, Chen MJ, Chang WH, Chan YJ, Wang HY, Shih SC. Signet-ring type adenocarcinoma arising from a tiny gastric polyp. Gastrointest Endosc. 2008;67:724–725.

    Article  PubMed  Google Scholar 

  29. Dijkhuizen SMM, Entius MM, Clement MJ, et al. Multiple hyperplastic polyps in the stomach: Evidence for clonality and neoplastic potential. Gastroenterology. 1997;112:561–566.

    Article  PubMed  CAS  Google Scholar 

  30. Lauwers GY, Wahl SJ, Melamed J, Rojas-Corona RR. p53 expression in precancerous gastric lesions: an immunohistochemical study of Pab 1801 monoclonal antibody on adenomatous and hyperplastic gastric polyps. Am J Gastroenterol. 1993;88:1916–1919.

    PubMed  CAS  Google Scholar 

  31. Weiss MM, Kuipers EJ, Postma C, Snijders AM, Stolte M, et al. Genome wide array comparative genomic hybridisation analysis of premalignant lesions of the stomach. Mol Pathol. 2003;56:293–298.

    Article  PubMed  CAS  Google Scholar 

  32. Seruca R, Carneiro F, Castedo S, David L, Lopes C, Sobrinho-Simoes M. Familial gastric polyposis revisited: Autosomal dominant inheritance confirmed. Cancer Genet Cytogenet. 1991;53:97–100.

    Article  PubMed  CAS  Google Scholar 

  33. Carneiro F, David L, Seruca R, Castedo S, Nesland JM, Sobrinho-Simoes M. Hyperplastic polyposis and diffuse carcinoma of the stomach: A study of a family. Cancer. 1993;72:323–329.

    Article  PubMed  CAS  Google Scholar 

  34. Davion T, Lescanne-Darchis I, Maunoury V, et al. Hyperplastic gastric polyposis and familial colonic adenomas. Apropos of a case. Gastroenterol Clin Biol 1996;20:298–302.

    Google Scholar 

  35. Mochizuka A, Uehara T, Nakamura T, Kobayashi Y, Ota H. Hyperplastic polyps and sessile serrated ‘adenomas’ of the colon and rectum display gastric pyloric differentiation. Histochem Cell Biol. 2007;128:445–455.

    Article  PubMed  CAS  Google Scholar 

  36. Owens SR, Chiosea SI, Kuan SF. Selective expression of gastric mucin MUC6 in colonic sessile serrated adenoma but not in hyperplastic polyp aids in morphological diagnosis of serrated polyps. Mod Pathol. 2008;21:660–669.

    Article  PubMed  CAS  Google Scholar 

  37. Yao T, Nishiyama KI, Oya M, Kouzuki T, Kajiwara M, Tsuneyoshi M. Multiple serrated adenocarcinomas of the colon with a cell lineage common to metaplastic polyp and serrated adenoma: Case report of a new subtype of colonic adenocarcinoma with gastric differentiation. J Pathol. 2000;190:444–449.

    Article  PubMed  CAS  Google Scholar 

  38. Snover DC, Jass JR, Fenoglio-Preiser C, Batts KP. Serrated polyps of the large intestine: A morphologic and molecular review of an evolving concept. Am J Clin Pathol. 2005;124:380–391.

    Article  PubMed  Google Scholar 

  39. Liang JJ, Alrawi S, Tan D. Nomenclature, molecular genetics and clinical significance of the precursor lesions in the serrated polyp pathway of colorectal carcinoma. Int J Clin Exp Pathol. 2008;1:317–324.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Pathology, University Health Network/University of Toronto, Toronto, ON, Canada

    Richa Jain & Runjan Chetty

  2. Department of Pathology, University Health Network/Toronto Medical Laboratories, The Toronto General Hospital, 200 Elizabeth Street, 11th Floor, Eaton Wing, Toronto, ON, Canada, M5G 2C4

    Runjan Chetty

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  1. Richa Jain
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Correspondence to Runjan Chetty.

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Jain, R., Chetty, R. Gastric Hyperplastic Polyps: A Review. Dig Dis Sci 54, 1839–1846 (2009). https://doi.org/10.1007/s10620-008-0572-8

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  • DOI: https://doi.org/10.1007/s10620-008-0572-8

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