Differential Diagnoses and Management Approaches for Gastric Polyposis
Abstract
:1. Introduction
2. Gastrointestinal Polyposis Syndromes with Gastric Polyps
2.1. Familial Adenomatous Polyposis
2.2. Peutz-Jeghers Syndrome
2.3. Cowden Syndrome
2.4. Cronkhite-Canada Syndrome
2.5. Juvenile Polyposis Syndrome
2.6. Gastric Adenocarcinoma and Proximal Polyposis of the Stomach
3. Gastric Polyposis Observed Outside of Gastrointestinal Polyposis Syndrome
3.1. Neuroendocrine Tumors in Autoimmune Gastritis
3.2. Proton Pump Inhibitor-Related Gastric Mucosal Changes
3.3. Multiple Submucosal Heterotopic Glands
4. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Disease Name | Causative Factor | Characteristics of Gastric Polyps |
---|---|---|
Familial adenomatous polyposis | Mutations in the APC gene | Multiple fundic gland polyps are typical. Intestinal-type adenomas and early gastric cancers exhibit reddish depressed lesions, while gastric-type adenomas display whitish elevated lesions. |
Peutz-Jeghers syndrome | Mutations in the STK11 gene | Solitary or sporadic polyps larger than 5 mm exhibiting a reddish color with a sessile or semi-pedunculated morphology (hyperplastic polyps and Peutz-Jeghers polyps), and multiple sessile polyps of 5 mm or smaller, mirroring the color of the peripheral mucosa (fundic gland polyps and hyperplastic polyps). |
Cowden syndrome | Mutations in the PTEN gene | Polyps generally exhibit a color similar to the peripheral mucosa but may also be reddish (hyperplastic, hamartomatous, inflammatory, lipomatous, fibromatous, and adenomatous polyps). |
Cronkhite-Canada syndrome | Not yet elucidated | Gastric polyps ranging from several millimeters to 20 mm in size are observed diffusely as sessile or slightly pedunculated elevations with a dense distribution. Edema with inflammation is present in the intervening mucosa between the polyps. |
Juvenile polyposis syndrome | Mutations in the SMAD4 or BMPR1A gene | Papillary or tongue-like polyps, multiple and reddish in color of varying sizes with swollen or edematous features. |
GAPPS | Mutations in the APC exon 1B promotor region | Polyps localized in the gastric body and fornix, predominantly constituted by fundic gland polyps manifesting as regions of dysplasia and adenocarcinoma in some patients. |
Neuroendocrine tumors in autoimmune gastritis | Autoimmune gastritis | Yellow or red tumors are identified in the gastric body with marked or prevailing atrophy localized within the gastric body while sparing the gastric antrum. |
Proton pump inhibitor-related gastric mucosal changes | Prolonged intake of proton pump inhibitors | Multiple white and flat elevated lesions, cobblestone-like mucosa, the emergence and enlargement of the fundic gland, and hyperplastic polyps. |
Multiple submucosal heterotopic glands | Chronic inflammation, such as infection of Helicobacter pylori | Polypoid lesions with cystic areas beneath the gastric mucosa visualized during an endoscopic ultrasound examination. |
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Iwamuro, M.; Kawano, S.; Otsuka, M. Differential Diagnoses and Management Approaches for Gastric Polyposis. Gastroenterol. Insights 2024, 15, 122-144. https://doi.org/10.3390/gastroent15010009
Iwamuro M, Kawano S, Otsuka M. Differential Diagnoses and Management Approaches for Gastric Polyposis. Gastroenterology Insights. 2024; 15(1):122-144. https://doi.org/10.3390/gastroent15010009
Chicago/Turabian StyleIwamuro, Masaya, Seiji Kawano, and Motoyuki Otsuka. 2024. "Differential Diagnoses and Management Approaches for Gastric Polyposis" Gastroenterology Insights 15, no. 1: 122-144. https://doi.org/10.3390/gastroent15010009