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Difference between revisions of "Fundic gland polyp"
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→Multiple polyps with PPI use: tweak
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| Site = [[stomach]] - usually fundus | | Site = [[stomach]] - usually fundus | ||
| Assdx = [[gastroesophageal reflux disease]] - thus PPI use | | Assdx = [[gastroesophageal reflux disease]] - thus PPI use | ||
| Syndromes = [[familial adenomatous polyposis]] | | Syndromes = [[familial adenomatous polyposis]], [[gastric adenocarcinoma and proximal polyposis of the stomach]] | ||
| Clinicalhx = | | Clinicalhx = | ||
| Signs = | | Signs = | ||
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*Associated with chronic proton pump inhibitors (PPI) use -- approximately 4x risk.<ref>{{cite journal |author=Jalving M, Koornstra JJ, Wesseling J, Boezen HM, DE Jong S, Kleibeuker JH |title=Increased risk of fundic gland polyps during long-term proton pump inhibitor therapy |journal=Aliment. Pharmacol. Ther. |volume=24 |issue=9 |pages=1341-8 |year=2006 |month=November |pmid=17059515 |doi=10.1111/j.1365-2036.2006.03127.x |url=}}</ref> | *Associated with chronic proton pump inhibitors (PPI) use -- approximately 4x risk.<ref>{{cite journal |author=Jalving M, Koornstra JJ, Wesseling J, Boezen HM, DE Jong S, Kleibeuker JH |title=Increased risk of fundic gland polyps during long-term proton pump inhibitor therapy |journal=Aliment. Pharmacol. Ther. |volume=24 |issue=9 |pages=1341-8 |year=2006 |month=November |pmid=17059515 |doi=10.1111/j.1365-2036.2006.03127.x |url=}}</ref> | ||
**PPIs may cause ''fundic gland polyposis'' - extremely rare (two reported cases as of 2012).<ref name=pmid22348851>{{Cite journal | last1 = Hegedus | first1 = I. | last2 = Csizmadia | first2 = C. | last3 = Lomb | first3 = Z. | last4 = Cseke | first4 = L. | last5 = Enkh-Amar | first5 = Y. | last6 = Pajor | first6 = L. | last7 = Bogner | first7 = B. | title = [Massive fundic gland polyposis caused by chronic proton pump inhibitor therapy]. | journal = Orv Hetil | volume = 153 | issue = 9 | pages = 351-6 | month = Mar | year = 2012 | doi = 10.1556/OH.2012.29313 | PMID = 22348851 }}</ref> | **PPIs may cause ''fundic gland polyposis'' - extremely rare (two reported cases as of 2012).<ref name=pmid22348851>{{Cite journal | last1 = Hegedus | first1 = I. | last2 = Csizmadia | first2 = C. | last3 = Lomb | first3 = Z. | last4 = Cseke | first4 = L. | last5 = Enkh-Amar | first5 = Y. | last6 = Pajor | first6 = L. | last7 = Bogner | first7 = B. | title = [Massive fundic gland polyposis caused by chronic proton pump inhibitor therapy]. | journal = Orv Hetil | volume = 153 | issue = 9 | pages = 351-6 | month = Mar | year = 2012 | doi = 10.1556/OH.2012.29313 | PMID = 22348851 }}</ref> | ||
*[[Gastric adenocarcinoma and proximal polyposis of the stomach]].<ref name=pmid21813476>{{Cite journal | last1 = Worthley | first1 = DL. | last2 = Phillips | first2 = KD. | last3 = Wayte | first3 = N. | last4 = Schrader | first4 = KA. | last5 = Healey | first5 = S. | last6 = Kaurah | first6 = P. | last7 = Shulkes | first7 = A. | last8 = Grimpen | first8 = F. | last9 = Clouston | first9 = A. | title = Gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS): a new autosomal dominant syndrome. | journal = Gut | volume = 61 | issue = 5 | pages = 774-9 | month = May | year = 2012 | doi = 10.1136/gutjnl-2011-300348 | PMID = 21813476 }}</ref> | |||
Notes: | Notes: | ||
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*Polyp - usuallly in fundus, may be in body of stomach. | *Polyp - usuallly in fundus, may be in body of stomach. | ||
===Images=== | |||
<gallery> | <gallery> | ||
Image:Endoscopic_view_of_fundic_gland_polyps.jpg | FGPs on endoscopy. (WC) | Image:Endoscopic_view_of_fundic_gland_polyps.jpg | FGPs on endoscopy. (WC) | ||
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COMMENT: | COMMENT: | ||
Several fundic gland polyps were removed previously. Fundic gland | Several fundic gland polyps were removed previously. Fundic gland | ||
polyps are associated with familial adenomatous polyposis (FAP) | polyps are associated with familial adenomatous polyposis (FAP), | ||
gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS), | |||
and proton pump inhibitor (PPI) use. | and proton pump inhibitor (PPI) use. | ||
PPI use appears to be the most likely explanation in this case, | PPI use appears to be the most likely explanation in this case, | ||
in the context of the provided history; however, FAP should be | in the context of the provided history; however, FAP and GAPPS should be | ||
considered clinically. | considered clinically. | ||
</pre> | </pre> | ||
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- Fundic gland polyposis, see comment. | - Fundic gland polyposis, see comment. | ||
- NEGATIVE for intestinal metaplasia. | - NEGATIVE for intestinal metaplasia. | ||
- NEGATIVE for | - NEGATIVE for Helicobacter-like organisms. | ||
- NEGATIVE for dysplasia and negative for malignancy. | - NEGATIVE for dysplasia and negative for malignancy. | ||
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were seen at the time of grossing. | were seen at the time of grossing. | ||
Fundic gland polyps are reported in association with proton pump inhibitor use | Fundic gland polyps are reported in association with proton pump inhibitor use, familial | ||
adenomatous polyposis (FAP), and gastric adenocarcinoma and proximal polyposis of the | |||
stomach (GAPPS). The possibility of FAP and GAPPS should be considered. | |||
</pre> | </pre> | ||
| Line 128: | Line 130: | ||
were seen at the time of grossing. | were seen at the time of grossing. | ||
Fundic gland polyps are reported in association with proton pump inhibitor use | Fundic gland polyps are reported in association with proton pump inhibitor use, familial | ||
adenomatous polyposis (FAP), and gastric adenocarcinoma and proximal polyposis of the | |||
stomach (GAPPS). The possibility of FAP and GAPPS should be considered. | |||
</pre> | </pre> | ||