Two rare gastric hamartomatous inverted polyp cases suggest the pathogenesis of growth

Mori, Hideki; Kobara, Hideki; Tsushimi, Takaaki; Fujihara, Shintaro; Nishiyama, Noriko; Matsunaga, Tae; Ayaki, Maki; Yachida, Tatsuo; Masaki, Tsutomu

doi:10.3748/wjg.v20.i19.5918

Cited by 16 publications

(45 citation statements)

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“…1 To date, 40 cases of gastric IHP, including this case, have been reported in the English medical literature. [1][2][3][4][5][6] Gastric IHPs were located mainly in the submucosa or the inside of the muscularis mucosa. Preferential sites within the stomach were the fundus and body (the upper half of stomach), and the size of gastric IHPs ranged from 0.5 to 11 cm.…”

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confidence: 90%

“…To date, 40 cases, including the case described in this report, have been reported. [1][2][3][4] We experienced an extremely rare histopathological transformation of a gastric IHP: an inflammatory myofibroblast tumor (IMT) arising within a gastric IHP, defined as a 'IMT-like stromal proliferation within gastric IHP', indicating a clinically borderline tumor, in an adult patient. We describe the characteristics of this lesion and provide a review of the relevant literature.A 58-year-old female patient was admitted to the department of internal medicine for assessment of the physical check-up abnormality of a submucosal tumor.…”

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confidence: 99%

“…One hypothesis speculates that after hyperplastic change occurs in the submucosa, a connection between the inflamed covering mucosa and a submucosal hyperplastic lesion is made due to repeated chronic gastritis, leading to exposure of the hyperplastic submucosal Letter to the Editor lesion. 1 Another hypothesis suggests that the overlying gastric hyperplastic mucosa is inverted into the submucosa due to a break in the friable and thinning muscularis mucosa, resulting in submucosal entrapment of the gastric hyperplastic mucosa. 1 To date, 40 cases of gastric IHP, including this case, have been reported in the English medical literature.…”

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confidence: 99%

“…1 Another hypothesis suggests that the overlying gastric hyperplastic mucosa is inverted into the submucosa due to a break in the friable and thinning muscularis mucosa, resulting in submucosal entrapment of the gastric hyperplastic mucosa. 1 To date, 40 cases of gastric IHP, including this case, have been reported in the English medical literature. [1][2][3][4][5][6] Gastric IHPs were located mainly in the submucosa or the inside of the muscularis mucosa.…”

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Inflammatory myofibroblastic tumor‐like stromal proliferation within gastric inverted hyperplastic polyp

Noh

Min

Sung

et al. 2015

Pathology International

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Inflammatory myofibroblastic tumor-like stromal proliferation within gastric inverted hyperplastic polypTo the Editor: Gastric inverted hyperplastic polyp (IHP), a rare type of gastric polyp, is a downward-growing lesion composed of the proliferative gastric mucosal components of foveolar-, pyloric-, fundic-, or mixed-type epithelium that protrudes into the submucosal layer, mimicking a submucosal tumor. The pathogenesis of gastric IHP remains to be elucidated, although several hypotheses have been suggested. To date, 40 cases, including the case described in this report, have been reported. 1-4 We experienced an extremely rare histopathological transformation of a gastric IHP: an inflammatory myofibroblast tumor (IMT) arising within a gastric IHP, defined as a 'IMT-like stromal proliferation within gastric IHP', indicating a clinically borderline tumor, in an adult patient. We describe the characteristics of this lesion and provide a review of the relevant literature.A 58-year-old female patient was admitted to the department of internal medicine for assessment of the physical check-up abnormality of a submucosal tumor. She had no noticeable symptoms or medical or operational history with the exception that she was a 5 pack-years smoker. Her clinical physical examination was unremarkable and labora-

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Inflammatory myofibroblastic tumor‐like stromal proliferation within gastric inverted hyperplastic polyp

Noh

Min

Sung

et al. 2015

Pathology International

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“…As such, diagnostic resections have been performed in many cases of GHIP. Such resections are performed by endoscopic submucosal dissection (ESD) or laparoscopic and endoscopic cooperative surgery (LECS) in clinical practice, because GHIP is considered a benign disease [3][4][5]. However, although relatively uncommon, it has been reported GHIP occasionally contains gastric cancer [5,6] and can manifest as a central dimple or umbilication [7].…”

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Diagnosis and treatment of gastric hamartomatous inverted polyp (GHIP) using a modified combination of laparoscopic and endoscopic approaches to neoplasia with a non-exposure technique (modified CLEAN-NET): a case report

et al. 2020

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Background: Gastric hamartomatous inverted polyp (GHIP) is a pathological condition where enlarged gastric glands with cystic dilatation grow in the submucosa. It is difficult to excise the tissue due to its location. In addition, even if the tissue is taken correctly, making an accurate diagnosis is difficult due to foveolar epithelium in the tissue, which can be misdiagnosed as gastric mucosal epithelium. Thus, an accurate diagnosis of GHIP is rarely established from a biopsy alone preoperatively. We here report a case of GHIP with a central dimple, which was diagnosed and treated using a modified combination of laparoscopic and endoscopic approaches to neoplasia with a non-exposure technique (modified CLEAN-NET). Case presentation: A 60-year-old man with a submucosal tumor (SMT) in the stomach was referred to our hospital by a primary care doctor. On examination, a gastrointestinal stromal tumor was suspected. Modified CLEAN-NET was performed for diagnostic and therapeutic purposes. The histopathological examination of the resected specimen showed an enlarged gland duct in the submucosal layer. This finding, along with immunostaining results, led to the diagnosis of GHIP. The postoperative course was uneventful without any symptoms. Conclusions: GHIP should be considered among the differential diagnoses of SMT of the stomach. Modified CLEAN-NET may be beneficial in the removal of SMTs such as GHIP with a central dimple because it can avoid stomach deformation of the stomach and tumor dissemination.

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Gastric hamartomatous inverted polyp: Report of three cases with a review of the endoscopic and clinicopathological features

et al. 2023

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Objectives A gastric hamartomatous inverted polyp (GHIP) is a rare submucosal tumor characterized histopathologically by a submucosal inverted proliferation of cystically dilated hyperplastic gastric glands. Only 42 GHIPs have been reported in English literature. Few GHIPs have been reported to accompany adenocarcinomas. We reported on three patients with a GHIP and reviewed the clinicopathological and endoscopic features of GHIPs. Methods This study included two men and one woman with a GHIP. The endoscopic, histopathological, and immunohistochemical features of the endoscopically resected specimens were analyzed. A gene mutation analysis was also performed. Results All the tumors were located in the body of the stomach, with a median size of 20 mm. Two tumors were sessile, and the remaining tumor had a pedunculated appearance. The overlying mucosa mainly appeared normal but was reddish in one tumor. The histopathological examination of the tumors revealed a well‐circumscribed and lobular submucosal proliferation of cystically dilated hyperplastic glands. The immunohistochemical analysis revealed that the MUC5AC‐positive foveolar epithelium was located in the center, and MUC6‐positive pseudo‐pyloric or pepsinogen‐I and H + /K + ATPase‐positive fundic‐type glands were located at the periphery of two tumors. No carcinomatous components were noted in any of the tumors. Moreover, no significant mutations in oncogenes or tumor suppressor genes were noted. Conclusions Our review revealed that approximately three fourths of GHIP cases showed an submucosal tumor‐like feature, whereas endoscopic features, including the endoscopic ultrasonography findings, were not characteristic. Because an endoscopic diagnosis of a GHIP may be difficult, complete endoscopic resection may be required for a pathological diagnosis.

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Two rare gastric hamartomatous inverted polyp cases suggest the pathogenesis of growth

Cited by 16 publications

References 15 publications

Inflammatory myofibroblastic tumor‐like stromal proliferation within gastric inverted hyperplastic polyp

Inflammatory myofibroblastic tumor‐like stromal proliferation within gastric inverted hyperplastic polyp

Diagnosis and treatment of gastric hamartomatous inverted polyp (GHIP) using a modified combination of laparoscopic and endoscopic approaches to neoplasia with a non-exposure technique (modified CLEAN-NET): a case report

Gastric hamartomatous inverted polyp: Report of three cases with a review of the endoscopic and clinicopathological features

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