Gastric Polyp

Gastric polyps are projections of mucosal or submucosal tissue into the stomach lumen, representing many tissue types with a spectrum of malignant potential. The prevalence of gastric polyps in the general population is estimated to be 2%, but reports vary. Most gastric polyps are found incidentally during esophagogastroduodenoscopy (EGD), and it is reported that polypoid lesions are reported during approximately 6% of EGD procedures. Most upper endoscopies are performed for gastroesophageal reflux, dyspepsia, anemia, and abdominal pain. Common types of gastric polyps are fundic gland polyps, featuring dilated and irregularly budded fundic glands, hyperplastic polyps, characterized by pronounced foveolar hyperplasia, and adenomatous polyps that demonstrate low-grade glandular dysplasia.

Additional gastric lesions encountered on EGD include neuroendocrine tumors, hamartomatous lesions such as those found in Peutz-Jegher, Cowden, and juvenile polyposis syndromes, ectopic pancreatic tissue, lymphoid proliferation, and mesenchymal growths such as gastrointestinal stromal tumors, leiomyoma and fibroid polyps. Diagnosing a polyp based on visualization is often difficult, and biopsy with histologic evaluation is usually necessary. Most polyps are asymptomatic, but larger polyps may cause abdominal pain, bleeding, or obstruction. Hyperplastic polyps, which often proliferate in response to atrophic gastritis, may give rise to iron deficiency anemia and are correlated with pernicious anemia. There is an association between dyspepsia and fundic gland polyps, and possibly a connection between fundic gland polyps and prolonged use of a proton pump inhibitor.