Inflammatory esophagogastric polyp and fold in an adolescent

Abstract

The case of a 13 year old boy with an inflammatory esophagogastric polyp and ulcerative colitis is described. Endoscopy revealed a typical polyp and gastric fold complex at the esophagogastric junction and a hiatal hernia. Histology of a biopsy specimen confirmed an inflammatory polyp covered by hyperplastic squamous and gastric foveolar epithelium. Continuous 24 hour esophageal manometry suggested gastroesophageal reflux, which may be related to the pathogenesis of the lesion. Follow‐up endoscopy showed marked regression of the polyp with medication for reflux eosphagitis. This clinical entity is rare in childhood and adolescence, and the manifestations may not be readily recognized. Therefore, endoscopic biopsy is important in children with esophageal polyps. However, polypectomy is unnecessary except when malignancy is suspected or when symptoms persist.

Multiple squamous hyperplastic-fibrous inflammatory polyps of the oesophagus: a new feature of eosinophilic oesophagitis?

“…Oesophageal polyps are rare and have been described in isolated reports in the medical literature 2 3. The aetiology of oesophageal polyps is unknown.…”

Two Hyperplastic Esophagogastric Polyps in a Child with Neurofibromatosis Type 1 (NF-1)

“…There are few documented instances of such polyps occurring in the pediatric population [2,3,[5][6][7][8][9][10][11]; most of these are case reports in the clinical or radiological literature, with little emphasis on the pathology. Included in this group are reports of the ''inflammatory polyp-fold'' complex in children, which is a clinical entity defined originally by Bleshman and colleagues [12] as a firm round lesion at the gastroesophageal junction, often in continuity with a prominent gastric fold, as appreciated by radiology or endoscopic studies.…”

“…In many of the case reports the polyp is described as comprising gastric mucosa with no mention of hyperplasia, with or without edema and, occasionally, with squamous epithelium present in the stalk [5][6][7][8][9][10][11]. Kato and colleagues [2] report the case of a 13-year-old male with a history of ulcerative colitis and with the endoscopic findings of the polyp-fold complex. Histology of the esophagogastric polyp showed hyperplastic squamous and gastric foveolar epithelium.…”

“…There are only a handful of reports of esophagogastric polyps in the pediatric population. Most of these only describe chronic inflammation within the lamina propria of the polyp, with only rare reports specifying the presence of epithelial hyperplasia [2,3]. De Giacomo and colleagues [4] presented 2 cases of hyperplastic esophagogastric polyps in children with neurofibromatosis type 1 (NF-1) in a single article, one in a 10-year-old male with vomiting and epigastric pain and the other in an 18-month-old female with growth failure and food refusal.…”

Gastric Cardiac Polyps

“…Originally reported by radiologists as exuberant growths in the pouch of patients with hiatal hernia, 3,9 they were thought to be related to gastroesophageal reflux disease (GERD), to the point of being named "the reflux gastroesophageal polyp." 2,11,13,16,23 Since then, there have been reports of individual cases or small series, some of which refuted the link with reflux. 18 The first systematic histopathologic analyses of these lesions did not come up until the early 2000s.…”