Coexistence of Gastric Hyperplastic Polyp and Polypoid Foveolar Hyperplasia: A Case Report

• Published in: National journal of laboratory medicine Vol. 13; no. 3; pp. 13 - 15
• Main Authors: Aishwarya Prasad Nair, Thanka Johnson, Rajendran Shanmugasundaram
• Format: Journal Article
• Language: English
• Published: JCDR Research and Publications Pvt. Ltd 01-07-2024
• Subjects: corkscrew-like pattern; malignant transformation; tortuous foveolae
• ISSN: 2277-8551; 2455-6882
• DOI: 10.7860/NJLM/2024/69874.2862

Benign gastric epithelial lesions, known as gastric hyperplastic polyps, include concomitant inflammatory alterations and elongated or convoluted foveolae and cystically dilated glands. It is believed that polypoid foveolar hyperplasia, a regenerative lesion associated with both acute and chronic mucosal damage, as well as, chronic gastritis, may serve as a precursor to gastric hyperplastic polyps. In the presented case, a 64-year-old female with a history of Helicobacter pylori (H. pylori)-associated chronic gastritis complained of abdominal pain, heartburn and regurgitation for one year. During endoscopy, three polyps were identified, one at the gastroesophageal junction, another below the gastroesophageal junction, and a third at the distal body of the stomach, of which only two polyps were sent for HPE. Gross inspection revealed that both soft-tissue masses were globular, with the cut-section of the polyp from the stomach’s distal body showing haemorrhagic areas. Under the microscope, the polyp from the stomach’s distal body revealed hyperplastic foveolar epithelium that was distorted, branching, elongated and dilated, situated in an oedematous, inflammatory stroma. The polyp just below the gastroesophageal junction displayed characteristics of polypoid foveolar hyperplasia, including elongated pits devoid of dilation features. The final diagnosis for the polyp from the distal body of the stomach was gastric hyperplastic polyp, and the polyp from just below the gastroesophageal junction was diagnosed as polypoid foveolar hyperplasia. Malignant transformation affects hyperplastic polyps, but foveolar polypoid hyperplasia remains unaffected, underscoring the importance of careful and diligent examination to distinguish between the two conditions.