Difference between revisions of "Fundic gland polyp"
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*Weak association with FAP ([[familial adenomatous polyposis]]).<ref name=pmid20567540/><ref name=pmid18322941>{{cite journal |author=Freeman HJ |title=Proton pump inhibitors and an emerging epidemic of gastric fundic gland polyposis |journal=World J. Gastroenterol. |volume=14 |issue=9 |pages=1318-20 |year=2008 |month=March |pmid=18322941 |doi= |url=http://www.wjgnet.com/1007-9327/14/1318.asp}}</ref> | *Weak association with FAP ([[familial adenomatous polyposis]]).<ref name=pmid20567540/><ref name=pmid18322941>{{cite journal |author=Freeman HJ |title=Proton pump inhibitors and an emerging epidemic of gastric fundic gland polyposis |journal=World J. Gastroenterol. |volume=14 |issue=9 |pages=1318-20 |year=2008 |month=March |pmid=18322941 |doi= |url=http://www.wjgnet.com/1007-9327/14/1318.asp}}</ref> | ||
*Associated with chronic proton pump inhibitors (PPI) use -- approximately 4x risk.<ref>{{cite journal |author=Jalving M, Koornstra JJ, Wesseling J, Boezen HM, DE Jong S, Kleibeuker JH |title=Increased risk of fundic gland polyps during long-term proton pump inhibitor therapy |journal=Aliment. Pharmacol. Ther. |volume=24 |issue=9 |pages=1341-8 |year=2006 |month=November |pmid=17059515 |doi=10.1111/j.1365-2036.2006.03127.x |url=}}</ref> | *Associated with chronic proton pump inhibitors (PPI) use -- approximately 4x risk.<ref>{{cite journal |author=Jalving M, Koornstra JJ, Wesseling J, Boezen HM, DE Jong S, Kleibeuker JH |title=Increased risk of fundic gland polyps during long-term proton pump inhibitor therapy |journal=Aliment. Pharmacol. Ther. |volume=24 |issue=9 |pages=1341-8 |year=2006 |month=November |pmid=17059515 |doi=10.1111/j.1365-2036.2006.03127.x |url=}}</ref> | ||
**PPIs may cause ''fundic gland polyposis'' - extremely rare (two reported cases as of 2012).<ref name=pmid22348851>{{Cite journal | last1 = Hegedus | first1 = I. | last2 = Csizmadia | first2 = C. | last3 = Lomb | first3 = Z. | last4 = Cseke | first4 = L. | last5 = Enkh-Amar | first5 = Y. | last6 = Pajor | first6 = L. | last7 = Bogner | first7 = B. | title = [Massive fundic gland polyposis caused by chronic proton pump inhibitor therapy]. | journal = Orv Hetil | volume = 153 | issue = 9 | pages = 351-6 | month = Mar | year = 2012 | doi = 10.1556/OH.2012.29313 | PMID = 22348851 }}</ref> | |||
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Revision as of 18:17, 20 January 2014
| Fundic gland polyp | |
|---|---|
| Diagnosis in short | |
.jpg) Fundic gland polyp. H&E stain. | |
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| |
| LM | polypoid shape (epithelium on three sides), dilated gastric glands (flatted epithelial lining consisting of normal foveolar epithelium), lack of foveolar hyperplasia |
| LM DDx | hyperplastic polyp of the stomach, gastric columnar dysplasia |
| Gross | polyp - usu. fundus, may be in body of stomach |
| Site | stomach - usually fundus |
|
| |
| Associated Dx | gastroesophageal reflux disease - thus PPI use |
| Syndromes | familial adenomatous polyposis |
|
| |
| Symptoms | usu. asymptomatic |
| Prevalence | common |
| Endoscopy | polyps |
| Prognosis | benign |
| Clin. DDx | gastric adenoma, hyperplastic polyp of the stomach |
Fundic gland polyp, abbreviated FGP, is a relatively common pathology of the stomach. It is associated with familial adenomatous polyposis and proton pump inhibitor use.
General
Clinical significance
- Weak association with FAP (familial adenomatous polyposis).[1][2]
- Associated with chronic proton pump inhibitors (PPI) use -- approximately 4x risk.[3]
- PPIs may cause fundic gland polyposis - extremely rare (two reported cases as of 2012).[4]
Notes:
- Animal studies suggested PPIs cause neuroendocrine tumours -- but this has not been found in humans.[5]
Gross
- Polyp - usuallly in fundus, may be in body of stomach.
Image:
FGPs on endoscopy. (WC)
Microscopic
Features:[6]
- Polypoid shape (may not be appreciated on microscopy).
- Dilated gastric glands.
- Flatted epithelial lining (consisting of normal foveolar epithelium) - key feature.
Notes:
- The presence of dysplastic changes should prompt consideration of FAP.
DDx:
- Hyperplastic polyp of the stomach - has foveolar hyperplasia, gland dilation may be present.
- Gastric columnar dysplasia - esp. in the context of FAP.
Images
FGP - low mag. (WC)
FGP - high mag. (WC)
.jpg)
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POLYP, STOMACH, BIOPSY: - FUNDIC GLAND POLYP. - NEGATIVE FOR INTESTINAL METAPLASIA. - NEGATIVE FOR HELICOBACTER-LIKE ORGANISMS. - NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY.
See also
- Stomach.
- Neuroendocrine tumours.
- Gastric columnar dysplasia.
- Hyperplastic polyp of the stomach.
- Hyperplastic polyp of the colon and rectum.
References
- ↑ 1.0 1.1 1.2 Spiegel, A.; Stein, P.; Patel, M.; Patel, R.; Lebovics, E. (Jan 2010). "A report of gastric fundic gland polyps.". Gastroenterol Hepatol (N Y) 6 (1): 45-8. PMID 20567540.
- ↑ Freeman HJ (March 2008). "Proton pump inhibitors and an emerging epidemic of gastric fundic gland polyposis". World J. Gastroenterol. 14 (9): 1318-20. PMID 18322941. http://www.wjgnet.com/1007-9327/14/1318.asp.
- ↑ Jalving M, Koornstra JJ, Wesseling J, Boezen HM, DE Jong S, Kleibeuker JH (November 2006). "Increased risk of fundic gland polyps during long-term proton pump inhibitor therapy". Aliment. Pharmacol. Ther. 24 (9): 1341-8. doi:10.1111/j.1365-2036.2006.03127.x. PMID 17059515.
- ↑ Hegedus, I.; Csizmadia, C.; Lomb, Z.; Cseke, L.; Enkh-Amar, Y.; Pajor, L.; Bogner, B. (Mar 2012). "[Massive fundic gland polyposis caused by chronic proton pump inhibitor therapy].". Orv Hetil 153 (9): 351-6. doi:10.1556/OH.2012.29313. PMID 22348851.
- ↑ Masaoka T, Suzuki H, Hibi T (May 2008). "Gastric epithelial cell modality and proton pump inhibitor". J Clin Biochem Nutr 42 (3): 191-6. doi:10.3164/jcbn.2008028. PMC 2386521. PMID 18545640. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2386521/.
- ↑ URL: http://moon.ouhsc.edu/kfung/jty1/opaq/PathQuiz/A2B001-PQ01-M.htm. Accessed on: 19 October 2010.