Pathology Associates Of Lexington, P.A.
Pathology Associates Of Lexington, P.A.
Pathology Associates Of Lexington, P.A.
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        Gastric polyps and tumors
      
  • Polyps:
    • hyperplastic: foveolar cells increased
    • fundic gland:
      • parietal-cell-rich mucosa with some microcystically dilated neck areas; a certain percentage can become adenomatous in FAP families; we have found these in bariatric verticle gastroplasty specimens [L10-1409 as fundic gland polyposis].
      1. pseudopyloric-gland-rich mucosa with microcystic change [S10-8993] as one might seen in atrophic gastritis with "gastritis cystica polyposa" when polyps all lumenal & "gastritis cystica polyposa profunda" when also go intramural.
    • hamartoma: [L10-2214?].
    • adenomatous:
      1. gastric type:multilayered foveolar-type cells with dysplastic features (watch out for confusion with adenomatous-appearing, pseudo-adenomatous, sometimes micropapillary[S10-8993], reactive change in in a fundic or hyperplastic polyp)
      2. intestinal type: those just as seen in colonic adenoma.
  • Benign tumors:
    • carcinoid: see info here.
    • GIST: over 90% are CD117 positive; can be laporascopically wedge resected with clear margins [L07-9364].
  • Malignant tumors:
    • carcinoma:
      1. adenocarcinoma:
        • well-differentiated (acinar...glandular) adenocarcinoma problem: be on special alert with biopsies as there are two types of pathologists concerning well differentiated gastric cancer: (a) those who have missed a case; and, (b) those who will miss a case. The smallest we have seen (<5mm) was able to be resected with a single-snare, snare polypectomy [S07-12805].
        • early non-gland-forming adenocarcinoma: during MALT EGD surveillance, one of our docs noted a 2 x 1.5 cm. red area on the greater curve at junction of body & antrum in a Japanese patient; subtotal gastrectomy fresh specimen [LMC-03-2257] was carefully examined (visual & tactile) by two pathologists (combined experience of 35 years) & it was completely negative (final Dx: node neg. intramucosal grade 3 adenocarc.).
      2. atypical or malignant carcinoid, info here.
      3. treatment: no neoadjuvant chemo or XRT if node negative.
    • lymphoma:
    • plasmacytoma: [LMC-04-5089]
    • sarcoma:
    • GIST
(posted 29 October 2002; latest update 18 August 2010)
 
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