Abstract:
OBJECTIVES:Fundic gland polyps (FGPs) occur in two clinical settings, sporadic and syndromic. Epithelial dysplasia is rare in sporadic FGPs, and progression data from large series are lacking. The aim of this study was to evaluate the clinical, morphologic, and immunohistochemical features in a large series of sporadic FGPs with epithelial dysplasia. METHODS:We studied 85 patients with FGPs with low-grade dysplasia (FGPD), including 62 patients with sporadic and 23 with syndromic FGPDs. RESULTS:Sixty-two patients with sporadic FGPD comprised 29 men and 33 women with a median age of 56 years. The indications for endoscopy were heartburn and follow-up of Barrett esophagus, and 49 patients had a history of proton pump inhibitor use. Morphologically, sporadic and syndromic FGPDs were similar. Immunohistochemical staining for p53 was normal (weak 1+) in all polyps, Ki-67 immunohistochemistry showed staining in the mucus neck and surface epithelium, and nuclear accumulation of β-catenin was observed in 9 of 40 sporadic FGPDs. Twenty-six (42%) patients with sporadic FGPDs had follow-up esophagogastroduodenoscopies with biopsies after a mean period of 14.8 months (nine with more than one follow-up): nine (35%) had no additional polyps, 13 (50%) had nondysplastic sporadic FGPs, and four (15%) had sporadic FGPDs. CONCLUSIONS:Sporadic FGPDs were seen primarily in middle-aged patients with gastroesophageal reflux. Follow-up data support the indolent nature of these polyps.
journal_name
Am J Clin Patholjournal_title
American journal of clinical pathologyauthors
Levy MD,Bhattacharya Bdoi
10.1309/AJCPGK8QTYPUQJYLsubject
Has Abstractpub_date
2015-10-01 00:00:00pages
592-600issue
4eissn
0002-9173issn
1943-7722pii
144/4/592journal_volume
144pub_type
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