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Abstract

Gastritis cystica polyposa (GCP) is defined as a hyperplastic polyp containing foci of misplaced foveolar or glandular epithelium (or both) in the muscularis mucosa or in the deeper portions of submucosa and muscularis mucosa.1Odze R. Goldblum J. Surgical pathology of the GI tract, liver, biliary tract, and pancreas.2nd ed. Saunders, Philadelphia2009Google Scholar, 2Littler E.R. Gleibermann E. Gastritis cystica polyposa. (Gastric mucosal prolapse at gastroenterostomy site, with cystic and infiltrative epithelial hyperplasia).Cancer. 1972; 29: 205-209Crossref PubMed Scopus (143) Google Scholar The term heterotopic submucosal cyst of the stomach, mentioned in the letter, seems to have been used in some reports from the late 1970s, written mostly by Japanese physicians.3Oberman H.A. Lodmell J.G. Sower N.D. Diffuse heterotopic cystic malformation of the stomach.N Engl J Med. 1963; 269: 909-911Crossref PubMed Scopus (65) Google Scholar, 4Iwanaga T. Koyama H. Takahashi Y. et al.Diffuse submucosal cysts and carcinoma of the stomach.Cancer. 1975; 36: 606-614Crossref PubMed Scopus (70) Google Scholar, 5Yamagiwa H. Matsuzaki O. Ishihara A. et al.Heterotopic gastric glands in the submucosa of the stomach.Acta Pathol Jpn. 1979; 29: 347-350PubMed Google Scholar, 6Martel W. Oberman H.A. Heterotopic submucosal gastric cysts: report of two cases, one in association with carcinoma.Gastrointest Radiol. 1978; 3: 391-395Crossref PubMed Scopus (7) Google Scholar The condition was reported under several names, including multiple diffuse cystic disease, diffuse submucosal cystic disease, diffuse cystic glandular malformation, heterotopic gastric glands, and heterotopic submucosal gastric cysts.7Niizawa M. Ishida H. Morikawa P. et al.Diffuse heterotopic submucosal cystic malformation of the stomach: ultrasonographic diagnosis.Gastrointest Radiol. 1992; 17: 9-12Crossref PubMed Scopus (7) Google Scholar The word heterotopic is used to describe something in a place that does not exist in a normal condition, such as a heterotopic pancreas and adenomyosis. GCP is the cystic lesion lined with pyloric glands. Thus, GCP is not a heterotopic component of the stomach, as shown in our report and in the other reports.2Littler E.R. Gleibermann E. Gastritis cystica polyposa. (Gastric mucosal prolapse at gastroenterostomy site, with cystic and infiltrative epithelial hyperplasia).Cancer. 1972; 29: 205-209Crossref PubMed Scopus (143) Google Scholar, 8Ozenc A.M. Ruacan S. Aran O. Gastritis cystica polyposa.Arch Surg. 1988; 123: 372-373Crossref PubMed Scopus (15) Google Scholar, 9Béchade D, Desramé J, Algayres JP. Gastritis cystica profunda in an unoperated stomach 1: endoscopy. 2007;39(suppl 1):E80-1.Google Scholar, 10Park J.S. Myung S.J. Jung H.Y. et al.Endoscopic treatment of gastritis cystica polyposa found in an unoperated stomach.Gastrointest Endosc. 2001; 54: 101-103Abstract Full Text Full Text PDF PubMed Scopus (24) Google Scholar Though the pathogenesis of GCP is not fully understood, there are reports on adenocarcinoma arising at the site of GCP, which might be an explanation for the adenocarcinoma in our cases.11Qizilbash A.H. Gastritis cystica and carcinoma arising in old gastrojejunostomy stoma.Can Med Assoc J. 1975; 112: 1432-1433PubMed Google Scholar, 12Mitomi H. Iwabuchi K. Amemiya A. et al.Immunohistochemical analysis of a case of gastritis cystica profunda associated with carcinoma development.Scand J Gastroenterol. 1998; 33: 1226-1229Crossref PubMed Scopus (33) Google Scholar, 13Cho HJ, Kim JE, Jeong BJ, et-al. A case of gastric adenocarcinoma arising from gastritis cystica profunda [Korean]. 2004;28:237-41.Google Scholar Also, the development of GCP itself seemed to be limited to the previously operated stomach in former reports,2Littler E.R. Gleibermann E. Gastritis cystica polyposa. (Gastric mucosal prolapse at gastroenterostomy site, with cystic and infiltrative epithelial hyperplasia).Cancer. 1972; 29: 205-209Crossref PubMed Scopus (143) Google Scholar, 14Stemmermann G.N. Hayashi T. Hyperplastic polyps of the gastric mucosa adjacent to gastroenterostomy stomas.Am J Clin Pathol. 1979; 71: 341-345PubMed Google Scholar, 15Grieffel B. Engleberg M. Reiss R. Multiple polypoid cystic gastritis in old gastroenteric stoma.Arch Pathol. 1974; 97: 316-318PubMed Google Scholar but recent reports revealed the development of GCP in the unoperated stomach.9Béchade D, Desramé J, Algayres JP. Gastritis cystica profunda in an unoperated stomach 1: endoscopy. 2007;39(suppl 1):E80-1.Google Scholar, 10Park J.S. Myung S.J. Jung H.Y. et al.Endoscopic treatment of gastritis cystica polyposa found in an unoperated stomach.Gastrointest Endosc. 2001; 54: 101-103Abstract Full Text Full Text PDF PubMed Scopus (24) Google Scholar, 16Tuncer K. Alkanat M. Musoglu A. et al.Gastritis cystica polyposa found in an unoperated stomach: an unusual case treated by endoscopic polypectomy.Endoscopy. 2003; 35: 882Crossref PubMed Scopus (6) Google Scholar In conclusion, the definition of CGP coincides with our cases, showing polypoid masses in gross and numerous submucosal glandular cysts of various sizes in the microscopic view. Therefore, we think that GCP is the appropriate terminology describing our cases. Gastritis cystica polyposa in the operated stomach and heterotopic submucosal cysts in the unoperated stomachGastrointestinal EndoscopyVol. 71Issue 6PreviewTo the Editor: Full-Text PDF