Pathology Associates Of Lexington, P.A.

Gastric polyps and tumors

Polyps:
- hyperplastic: foveolar cells increased
- fundic gland: body-type mucosa with some microcystically dilated neck areas; a certain percentage can become adenomatous in FAP families
- hamartoma: [L10-2214?].
- adenomatous:
  1. gastric type: multilayered foveolar-type cells (watch out for confusion with adenomatous-appearing reactive change in in a fundic or hyperplastic polyp)
  2. intestinal type:
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 25 October 2007)