Clin Endosc.  2013 Sep;46(5):568-571.

A Case of Gastric Inverted Hyperplastic Polyp Found with Gastritis Cystica Profunda and Early Gastric Cancer

• Lee SJ
• Park JK
• Seo HI
• Han KH
• Kim YD
• Jeong WJ
• Cheon GJ
• Eom DW

Abstract

A gastric inverted hyperplastic polyp is a rare type of gastric polyp and is characterized by downward growth of a variety of mucosal components into the submucosa. The polyp consists of columnar cells resembling foveolar epithelium and pyloric gland epithelium and can coexist with gastritis cystica profunda. Frequently, adenocarcinoma can coexist, but the relation is not clear. A 77-year-old male underwent endoscopic submucosal dissection due to early gastric cancer. A gastric inverted hyperplastic polyp was found in the removed specimen and gastric cystica profunda was also found. We report a case of gastric inverted hyperplastic polyp coexisting with gastric cystica profunda and gastric adenocarcinoma.

Keyword

Stomach; Inverted hyperplastic polyp; Gastritis cystica profunda; Adenocarcinoma

MeSH Terms

Adenocarcinoma
Aged
Epithelium
Gastric Mucosa
Gastritis
Humans
Male
Polyps
Stomach
Stomach Neoplasms

Figure

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  Fig. 1 Gastroscopic finding. A 1.5-cm superficial depressed lesion surrounded by multiple nodularity with overlying normal mucosa is observed at the mid body of the stomach. In the center of the lesion, spontaneous bleeding is noted.

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  Fig. 2 Gross finding. (A) An endoscopic submucosal dissection (ESD) specimen, measuring 4×3.5×0.5-cm shows 1.5×0.5-cm superficial depressed lesion in the center and multiple markings on the periphery. (B) Mapping of ESD specimen reveals 1.5×0.5-cm-sized, well-differentiated, tubular adenocarcinoma (black color) in the center and gastritis cystica profunda (blue color) multifocally. An inverted hyperplastic polyp is located close to the well-differentiated tubular adenocarcinoma (red color). LC, lesser curvature; GC, greater curvature.

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  Fig. 3 Microscopic finding. (A) Low power view of the lesion shows well-differentiated adenocarcinoma in the mucosa (black box), gastritis cystica profunda in the submucosa (gray box), and inverted hyperplastic polyp in the submucosa (white box) at the same sight (H&E stain, ×10). (B) Well-differentiated adenocarcinoma is noted in the epithelium and lamina propria (black box, H&E stain, ×100). (C) It shows hyperplasia and cystic dilatation of the gastric glands extending to the submucosa layer (gray box, H&E stain, ×40). (D) It reveals a submucosal mass composed of proliferative glandular epithelial cells showing papillary and glandular growth (white box, H&E stain, ×40).

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