AGREEMENT BETWEEN DIFFERENT PATHOLOGISTS IN HISTOPATHOLOGIC DIAGNOSIS OF 128 GASTRIC POLYPS

ABSTRACT BACKGROUND - Gastric polyps are elevated mucosal lesions. Most of them are less than 1 cm and when larger than 2 cm, has a high malignancy probability. The histopathological types are mainly fundic gland polyps, hyperplastic polyps and adenomatous polyps. OBJECTIVE - To evaluate the agreement between three different pathologists in the histopathological diagnosis of 128 biopsied gastric polyps in Digestive Endoscopy Unit from Walter Cantídeo University Hospital, between May 2010 to May 2012. METHODS - To describe the intensity of agreement between observers, we use kappa index that is based on the number of concordant measures between them. RESULTS - There was substantial agreement in the diagnosis of adenoma (kappa=0.799, CI: 0.899-0.698) and fundic glands (kappa=0.655, CI: 0.755-0.555). Regarding to hyperplastic polyps (kappa=0.415, CI: 0.515-0.315) and inflammatory (kappa=0.401, CI: 0.501-0.301), we obtained a moderate agreement. Regarding the presence of Helicobacter pylori in biopsy of the polyp, there was a low agreement (kappa=0.219, CI: 0.319-0.119). CONCLUSION - It is clear that the agreement between pathologists depends on the histological type of the biopsied polyp and this agreement is more substantial in adenoma, or fundic gland polyps.

Download Full-text

Gastric polyps: a retrospective analysis of 26,000 digestive endoscopies

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032007000100004 ◽

2007 ◽

Vol 44 (1) ◽

pp. 14-17 ◽

Cited By ~ 66

Author(s):

Drausio Jefferson Morais ◽

Ademar Yamanaka ◽

José Murilo Robilotta Zeitune ◽

Nelson Adami Andreollo

Keyword(s):

Hyperplastic Polyp ◽

Gastric Polyp ◽

Adenomatous Polyps ◽

Fundic Gland ◽

Digestive Endoscopy ◽

Gastric Lesions ◽

Hyperplastic Polyps ◽

Gastric Polyps ◽

Fundic Gland Polyps ◽

Upper Digestive Endoscopy

BACKGROUND: Gastric polyps are small gastric lesions, asymptomatic in most cases and are generally discovered inadvertently during upper digestive endoscopy. AIM: To retrospectively review the characteristics and frequency of gastric polyps, derived from the gastric mucosal epithelium in a large series of endoscopies. METHODS: One hundred and fifty three patients in a series of 26,000 consecutive upper digestive endoscopies done over a 5-year period, being that each patient had only one examination were analyzed and their histological and Yamada classification, as well as their location, size, histopathological findings and treatment studied. All patients had at least one gastric polyp, as confirmed by histological examination. RESULTS: The polyps were classified as hyperplastic, adenomatous and fundic gland polyps. The most of them measure less than 1 cm (hyperplastic polyps - 60,5%; adenomatous polyps - 73,6%; fundic gland polyps - 72%). Hyperplastic polyps were the most frequent and accounted for 71.3% of the cases, whereas fundic gland polyps accounted for 16.3% and adenomatous polyps for 12.4%. Hyperplastic and adenomatous polyps were primarily single, whereas fundic gland polyps tended to be multiple. A carcinoma was detected in one hyperplastic polyp (0.9%) and in two adenomatous polyps (10.5%). High grade dysplastic foci were found in four adenomatous polyps (21%). CONCLUSIONS: The digestive endoscopy is the safest and efficient method for the diagnosis of the gastric polyps, that in most of the patients does not show characteristic symptoms. The histopathological definition is not possible to the endoscopic glance being needed the pathologist's aid, once the conduct to be adopted will depend on the result of the biopsy.

Download Full-text

Prevalence of gastric polypoid lesions in a single endoscopic centre

Orvosi Hetilap ◽

10.1556/oh.2013.29617 ◽

2013 ◽

Vol 154 (20) ◽

pp. 770-774

Author(s):

Ágnes Anna Csontos ◽

Bálint Fekete ◽

Katalin Lőrinczy ◽

Orsolya Terjék ◽

Lajos Berczi ◽

...

Keyword(s):

Proton Pump Inhibitor ◽

Proton Pump ◽

Chronic Gastritis ◽

Malignant Lesion ◽

Fundic Gland ◽

Hyperplastic Polyps ◽

Gastric Polyps ◽

Fundic Gland Polyps ◽

Upper Gastrointestinal

Background: The prevalence of gastric polyps is unknown in Hungary. Aim: The aim of the authors was to assess the prevalence of polypoid lesions of the stomach in the endoscopic centre of the 2nd Department of Medicine, Semmelweis University. Methods: Results of upper gastrointestinal endoscopies carried out between March 2010 and June 2011 were analysed. Results: 193 cases with polyps were diagnosed in 4174 endoscopies (4.62%). Hyperplastic polyps, fundic gland polyps and malignant lesion were detected in 33.67%, 31.09% and 2.07% of the cases, respectively. Proton pump inhibitor use was more frequent among patients diagnosed with fundus gland polyps (p = 0.007), while hyperplastic polyps were diagnosed more frequently in patients with chronic gastritis (p = 0.032). Conclusions: The frequency of gastric polyps was higher than expected from data published in the literature. Long-term proton pump-inhibitor use and chronic gastritis were associated with fundus gland and hyperplastic polyps, respectively. Orv. Hetil., 2013, 154, 770–774.

Download Full-text

Gastric Polyps: A 10-Year Analysis Of 18496 Upper Endoscopies

10.21203/rs.3.rs-697435/v1 ◽

2021 ◽

Author(s):

Haythem Yacoub ◽

Norsaf Bibani ◽

Mériam Sabbah ◽

Nawel Bellil ◽

Asma Ouakaa ◽

...

Keyword(s):

High Frequency ◽

Histological Study ◽

Bleeding Risk ◽

Tertiary Hospital ◽

Endoscopic Polypectomy ◽

Fundic Gland ◽

Hyperplastic Polyps ◽

Gastric Polyps ◽

Fundic Gland Polyps ◽

Common Location

Abstract Background/Aims: Gastric polyps (GPs) are usually asymptomatic lesions of the upper gastrointestinal tract observed in 1-3% of esophagogastroduodenoscopies (EGD). The majority of polyps are benign. The aim of this study was to precise the frequency of different types of gastric polyps in our population, and to analyze their possible association with other factors.Materials and Methods: A total of 18496 consecutive patients undergoing EGD over a ten-year period (between 2007 and 2018) in a tertiary hospital were retrospectively reviewed. Eighty-six patients diagnosed with gastric polyps were analysed. Demographics, medical history of the patients, and indication for gastroscopy were collected. Morphological, histological characteristics of polyps, and therapeutic management data were also collected.Results: GPs were found in 86 out of 18496 (0.46%) reviewed EGD, corresponding to a total of 141 polyps. There were 64 female (74.4%) and 22 male patients (25.6%) with a sex ratio (M/F) of 0.34. The average age was 58.1 years. One hundred and forty one polyps were included, and histopathology was obtained on 127 GPs. The most common location was the fundus (59.6%) and 48.9% were smaller than 5 mm. The polyp was unique in 75.6% of cases. According to Paris classification, 80% of the polyps were sessile (Is). Hyperplastic polyps were the most common (55.9%) were hyperplastic polyps, followed by sporadic fundic gland polyps in 23 patients (18.1%), 7 (5.5%) were adenomas, and 4 (3.1%) were neuroendocrine tumors type 1. The following factors were associated with hyperplastic polyps: anemia (p= 0.022), single polyp (p= 0.025) and size ≥ 5mm (p= 0.048). Comparing hyperplastic polyps biopsies to resected polyps, no difference was found in the evolutionary profile of the 2 groups. A size less than 10 mm (p=0.013) was associated with fundic gland polyps. Sixty polyps (47.2%) were treated by cold forceps, 19 (15%) treated by a mucosal resection and 15 (11.8%) with diathermic snare. Five procedural bleeding incidents were observed (3.9%). Only the use of anticoagulant treatment was associated with a high bleeding risk (p= 0.005). The comparative histological study between specimens of biopsied GPs and endoscopic polypectomy led to an overall agreement of 95.3%.Conclusion: In our study, the GPs frequency was 0.36%. Hyperplastic polyps and fundic gland are the most common gastric polyps in our country. The high frequency of Helicobacter pylori infection in our patients and in our area may explain the high frequency of HP.

Download Full-text

Epithelial gastric polyps

Pediatria i Medycyna Rodzinna ◽

10.15557/pimr.2021.0033 ◽

2021 ◽

Vol 17 (3) ◽

pp. 215-220

Author(s):

Monika Wdowiak ◽

Bartosz Kabała ◽

Bartłomiej Olak ◽

Bartosz Ostrowski

Keyword(s):

Clinical Symptoms ◽

Vascular Lesions ◽

Fundic Gland ◽

Hamartomatous Polyps ◽

Gastrointestinal Malignancies ◽

Gastric Polyps ◽

Fundic Gland Polyps ◽

Increased Risk ◽

Progressive Weight Loss ◽

Polyposis Syndromes

Gastric polyps are lesions projected above the mucosal surface, which are detected in approximately 1–6% of upper gastrointestinal endoscopies. Based to their shape, polyps are classified as pedunculate, semi-pedunculate, sessile and flat. Depending on the histopathological type, some of them have the potential to transform into adenocarcinoma. Polyps can be of epithelial and non-epithelial origin. The first group, which is discussed in greater detail in this paper, includes fundic gland polyps, hyperplastic, adenomatous and hamartomatous polyps. Non-epithelial polyps include stromal tumours, leiomyomas, fibrous inflammatory polyps, fibroids, fibromyomas, lipomas, ectopic pancreas, neuroendocrine tumours, neuromas, and some vascular lesions. Multiple polyps in patients under the age of 40 years require more extensive diagnosis for hereditary polyposis syndromes, which are associated with an increased risk of gastric cancer, as well as other gastrointestinal and extra-gastrointestinal malignancies. In recent years, there has been a clear decrease in the proportion of hyperplastic polyps and an increase in the proportion of fundic gland polyps among all gastric polyps, which is probably related to the increased use of proton pump inhibitors and a reduced incidence of Helicobacter pylori infections. About 90% of gastric polyps are detected accidentally and usually do not cause clinical symptoms, but large polyps may be responsible for anaemia, bloody stools, abdominal pain, and even pyloric obstruction, which may be manifested by vomiting, severe flatulence, lack of appetite or progressive weight loss.

Download Full-text

Automated detection of fundic gland polyps and hyperplastic polyps from endoscopic images using SSD

International Workshop on Advanced Imaging Technology (IWAIT) 2020 ◽

10.1117/12.2566318 ◽

2020 ◽

Author(s):

Koki Oshio ◽

Nagito Shichi ◽

Junichi Hasegawa ◽

Tomoyuki Shibata

Keyword(s):

Automated Detection ◽

Fundic Gland ◽

Hyperplastic Polyps ◽

Endoscopic Images ◽

Fundic Gland Polyps

Download Full-text

Gastric polypoid lesions detected on magnetic resonance cholangiopancreatography

10.21203/rs.3.rs-493398/v1 ◽

2021 ◽

Author(s):

Mitsuru Matsuki ◽

Isao Numoto ◽

Takefumi Hamakawa ◽

Kazunari Ishii ◽

Tomoyuki Otani

Keyword(s):

Magnetic Resonance ◽

Contrast Agent ◽

Magnetic Resonance Cholangiopancreatography ◽

Maximum Diameter ◽

Fundic Gland ◽

Oral Contrast ◽

Hyperplastic Polyps ◽

Oral Contrast Agent ◽

Fundic Gland Polyps ◽

The Mean

Abstract Background: On magnetic resonance cholangiopancreatography (MRCP) using a negative oral contrast agent, the gastric lumen appear dark, and gastric polypoid lesions can be seen. To our knowledge, there are no reports examining gastric polypoid lesions detected on MRCP.We exained the characteristics of gastric polypoid lesions detected on MRCP and discussed the management of the lesions.Material and Methods: MRCP images using a negative oral contrast agent were retrospectively evaluated in 1128 cases, and gastric polypoid lesions detected were investigated.Results: Gastric polypoid lesions were detected in 17 of the 1128 cases (1.5%) on MRCP. The mean patient age and gender were 66.7 years (range: 48-85 years) and 7 males / 10 females. A single lesion was detected in 4 cases, 2 to 4 lesions were detected in 6 cases, 5 to 10 lesions in 3 cases, and 11 or more in 4 cases. In 4 cases, the upper, middle, and lower portions of the stomach were occupied with polypoid lesions, in 4 cases, the upper and middle portions were occupied, in 1 case, the middle and lower portions were occupied, and in 8 cases, only the upper portion was occupied. One lesion was detected in 4 cases, 2 to 4 lesions were detected in 6 cases, 5 to 10 lesions in 3 cases, and 11 or more in 4 cases. The mean maximum diameter of the polypoid lesions was 7.8 mm (range: 4-16 mm). An upper endoscopy and forceps biopsy were performed in 9 of the 17 cases. The histological diagnosis was fundic gland polyps in 6 cases and hyperplastic polyps in 3 cases.Conclusion: Gastric polypoid lesions can rarely be detected on MRCP. The polypoid lesions were histologically fundic gland polyps or hyperplastic polyps. In the future, we will prospectively review more cases and examine indication of upper gastrointestinal endoscopy to gastric polypoid lesions detected on MRCP.

Download Full-text