Massive gastric juvenile‐type polyposis: a clinicopathological analysis of 22 cases

González, Raúl; Adsay, Volkan; Graham, Rondell P.; Shroff, Stuti G.; Feely, Michael; Drage, Michael G.; Lewin, David; Swanson, Eric A.; Yantiss, Rhonda K.; Bağcı, Pelin; Krasinskas, Alyssa M.

doi:10.1111/his.13149

Cited by 35 publications

(22 citation statements)

References 47 publications

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“…Sixteen percent of lesions defined as polyps did not have histopathological evidence of polyps or malignant histology. A previous study associated the high frequency of GFPs with long-term PPI use and low frequency of H. pylori infection [12] . In a previous study of 3024 endoscopic procedures, the most common type of polyp was HP [13,14] .…”

Section: Discussionmentioning

confidence: 96%

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Evaluation of gastric polyps in patients with upper gastrointestinal endoscopy

Zheng

Wen

Dai

et al. 2019

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BACKGROUNDAccording to the study population, incidence of gastric polyps (GP) varies from 0.33% to 6.7% in various studies. Most GPs consist of proliferative polyps (HP), gastric fundus polyps (FGP) and adenomatous polyps (APs). Despite the high malignant AP potential, sporadic FGP has no malignant potential. On the contrary, HP has a lower risk of potential harm. It is not sufficient to perform biopsies to determine the presence of polyp types and displacements, therefore, some polyps may require extensive biopsy or complete resection. METHODS This retrospective study included GP patients or polyphenic lesions with polyps or malignant histologyfound in polyps or gastroscopy at the Department of Gastroenterology, Shaanxi Hospital of Traditional Chinese Medicine from 2017 to 2019. RESULTSIn a series of 10.000 upper gastrointestinal endoscopy, 384 patients (0.38%) were found to have GPs.Of these patients, 98 (25.5) were male and 286(74.5) were female. The average age of the patients

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Section: Discussionmentioning

confidence: 96%

“…The distribution of different polypectomy methods with snare is given inTable 3. In patients undergoing sectional polypectomy, polyp diameter was 10.6 ± 4.1(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) mm. In 118 (92%) patients no complications related to polypectomy were observed.…”

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confidence: 99%

Evaluation of gastric polyps in patients with upper gastrointestinal endoscopy

Zheng

Wen

Dai

et al. 2019

Preprint

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“…Therefore, JPS cannot be excluded on the basis of a negative family history. Moreover, the histological identification of juvenile polyps may cause problems, as hyperplastic and juvenile polyps can be difficult if not impossible to distinguish in the stomach [5]. In the initial evaluation of this patient, resected gastric polyps were inaccurately characterized as hyperplastic polyps by 2 independent pathologists.…”

Section: Discussionmentioning

confidence: 97%

Gastric cancer and paraneoplastic dermatomyositis as complications of an unrecognized juvenile polyposis syndrome

et al. 2019

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Juvenile polyposis syndrome is a rare autosomal-dominant disorder characterized by multiple hamartomatous polyps in the gastrointestinal tract. It is associated with an increased risk of gastrointestinal cancer. We report the case of a 49-year-old woman presenting with proximal muscle weakness, weight loss, severe anemia, and melena. One year before, the diagnosis of a “fundic gland polyposis” was presumed after endoscopic evaluation for iron deficiency anemia had shown numerous polyps limited to the gastric mucosa. On admission, the diagnosis of dermatomyositis was made based on laboratory results with a marked elevated creatine kinase as well as the presence of characteristic clinical findings and muscle histology. Upper endoscopy revealed multiple pedunculated, edematous polyps in the stomach without apparent cancerous lesions intraluminally. Infiltration of the muscular layer was not detectable on endoscopic ultrasound. Histopathological examination of the polyps showed smooth outer surfaces and multiple dilated cystic glands, consistent with hamartomatous juvenile-type polyps. Magnetic resonance imaging revealed a peritoneal mass close to the greater curvature of the stomach, which was identified as a poorly differentiated adenocarcinoma by laparoscopic sampling. Immunohistochemical analysis of resected polyps was remarkable for a loss of SMAD4 expression, a finding that is very commonly observed in patients with gastric juvenile polyposis syndrome. Despite initial treatment response to glucocorticoids and chemotherapy, the patient died 5 months later due to progressive illness. Patients with gastric juvenile polyposis and SMAD4 mutations are at a high risk of developing gastric cancer; hence, early gastrectomy should be considered.

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“…We found that the most common symptoms of GPs were nausea, anemia and abdominal pain.The increasing incidence of gastric polyps in recent years may be attributed to the following reasons: a) an increasing number of people undergo endoscopy for health check-ups [10] ; b) environment and diet components have changed with socioeconomic development; and c) advances in endoscopic technology and its wide application have increased the positivity rate. The detection rate of gastric polyps was reported to be 6.35% in a population in the United States [11,12] ;…”

Section: Discussionmentioning

confidence: 99%

Evaluation of gastric polyps in patients with upper gastrointestinal endoscopy

zheng¹,

wen²,

Dai³

et al. 2020

Preprint

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Background:According to the study population, incidence of gastric polyps (GPs) varies from 0.33% to 6.7% in various studies. Most GPs consist of hyperplastic polyps (HPs), fundic gland polyps (FGPs), and adenomatous polyps (APs). Despite the high malignant APs potential, sporadic FGPs has no malignant potential. On the contrary, HPs has a lower risk of potential harm. It is not sufficient to perform biopsies to determine the presence of polyp types and displacements, therefore, some polyps may require extensive biopsy or complete resection. MethodsThis retrospective study included GPs patients or polyphenic lesions with polyps or malignant histology found in polyps or gastroscopy at the Department of Gastroenterology, Shaanxi Hospital of Traditional Chinese Medicine from 2017 to 2019.ResultsIn a series of 10.000 upper gastrointestinal endoscopy, 384 patients (3.84%) were found to have GPs. Of these patients, 98 (25.5) were male and 286(74.5) were female. The average age of the patients was 62.8±10.4 (36-75) years. HPs, APs and FGPs frequencies were 88.5%, 5.2% and 2.1%, respectively. The polyp size of 274 (71.3%) patients was ≤ 1 cm. Polyp was identified in 262 (68.2%) patients. The most common polyps are the antrum and the corpus. Endoscopic mucosal resection was performed on 128 patients. Bleeding events have been observed and endoscopic treatment is required after ESP.Conclusion: In current study, GPs frequency was low (3.84%), and HP frequency may be high due to high frequency of Helicobacter pylori (HPy) infection in China. Due to the high frequency of HPy infection and the short-term use of proton pump use, FGP frequency may be low.

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Massive gastric juvenile‐type polyposis: a clinicopathological analysis of 22 cases

Cited by 35 publications

References 47 publications

Evaluation of gastric polyps in patients with upper gastrointestinal endoscopy

Evaluation of gastric polyps in patients with upper gastrointestinal endoscopy

Gastric cancer and paraneoplastic dermatomyositis as complications of an unrecognized juvenile polyposis syndrome

Evaluation of gastric polyps in patients with upper gastrointestinal endoscopy

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