Gastric mucosal polyps.

Abstract

Most gastric epithelial polyps are best considered under the generic term of “mucosal polyps” because they contain the same basic histologic components whether or not atypical epithelial hyperplasia is present. A new classification of gastric mucosal polyps is proposed: (1) those without atypical hyperplasia; (2) those with atypical hyperplasia, including carcinomatous changes; and (3) a group not previously described, the antral-foveolar polyps. Polyps without atypia contain neutral epithelial mucosubstances with little acid or sulfated mucins. Increasing cytologic atypia is associated with histochemical and cytologic intestinal metaplasia, the former evidenced by the appearance of acidic and, sulfated mucins, and the latter by goblet and Paneth cells. In five of 44 patients (11%), the polyps contained histologic carcinomas, several of which invaded the stroma but did not metastasize. In addition, nine of 23 patients (39%) with gastric polyps developed cancers both in the stomach anci elsewhere in the gastrointestinal tract. Gastric mucosal polyps may be added to the list of harbingers of malignancy.