Mainly refers to the stomach by gastric epithelial polyps and / or proliferation of stromal elements arising from polypoid lesions. Normal gastric mucosa atrophy due to the surrounding mucosa, there intraluminal polypoid change. Proliferative changes, hypertrophy of the mucosa may also occur polypoid change. Proliferative changes can occur after focal or diffuse polypoid change. Gastric polyps are single and there are many mover. Patients who met 60-year-old female suffering from a case of multiple gastric polyps, polyps in the gastric body and fundus, the largest polyps 1. 5cm, the smallest polyps 0. 5cm, both for the broad-based type, polyps in bright red color to highlight in the stomach cavity. The import laser endoscopic resection, after the original symptoms of stomach discomfort disappears, since after good health, without any symptoms, eating well. Gastric polyps reported in the literature than the incidence of colon polyps rare, and occurred mostly in men over the age of 40, often in patients with chronic gastritis, when combined to form a single polyp majority.
1. Clinical classification according to the most commonly used are classified into renewable mings gastric polyps and neoplastic polyps two broad categories.
The first category is the regeneration of gastric polyps? ? Namely, proliferative rate of meat, the incidence of the more common, their share is about 76% ~ 90%. Found in parts of the stomach uncertainty, most tend to occur in parts of gastritis. Multiple accounts for the majority, the average diameter of 1cm, its surface was smooth and lobulated. Polyps from the long, slender finger ridge and well-differentiated similar to the pyloric glandular epithelium was composed of re-expansion of crypt. Irregular crypt was the branch shape and cystoid changes. The proliferation of epithelial cells in large, deep-dyed, single, nuclear located at the base, but the rare mitotic figures. Cytoplasm can be secreted mucus, pas-positive. Interstitial muscle for the mucosal surface of radial birth to the mucous membrane of smooth muscle bundles and collagen fibers, and sometimes a large number of vascular tumor-like polyps in the blood vessels and plasma cells and other inflammatory cell infiltration. Epithelial cells and intestinal metaplasia atypia not typical. Regenerative hyperplasia is mainly the result of rarely malignant.
The second category is the gastric adenoma. The disease is True adenomatous tumors, including adenomatous polyps and papillary and villous adenoma. With adenomatous histological and biological similarities. Gastric adenoma is much more rare than the stomach, accounting for 25% of all polyps. Occurred in the stomach mucosa, mostly by the proliferation of gastric mucous glands constituted.
(1), adenomatous polyps or polypoid adenoma, occurred in different parts of gastric mucosa, pyloric area about half of gastric adenomas of the more common type. Single most common can also be multiple. 'll Always be wide-based sessile, but also sometimes pedicle. Bi Zeng naturally large polyp size, diameter and usually about 2cm. Microscopic structure of the rules for the arrangement of tubular glands, glands expansion into the cystic occasionally. Gland has been re-single-layered columnar epithelium arranged in a more dense cytoplasm less activity to reduce mucus secretion and nuclear deep-dyed was columnar volume size of the same, showing mitotic figures. Common was born in intestinal epithelium of glands, the stroma mainly by fibrous tissue rich in blood vessels and the composition of which can be seen with varying degrees of plasma cells and lymphocytes infiltration.
(2), papillary adenoma or villous adenoma, the incidence in clinical rarely see. The naked eye can be showed papillary and villous, often as broad-based sessile, microscopic structure of columnar epithelial cells were re-branch-shaped cable core composed of connective tissue containing blood vessels. In fact, the above two types of adenoma often exist in mixed within the same polyp. Diameter of more than 2cm of polyps, often glandular atypia hyperplasia and even carcinoma in situ and invasive carcinoma. Gland hyperplasia atypia manifested in the glandular epithelium from high columnar to low columnar, increased mitotic figures. Cube, mucus secretion decreased eosinophilic cytoplasm increased and that the nuclear increase, chromatin increased, irregular nuclear arrangement. In the event of carcinoma in situ, the changes described above increased at the same time shaped gland budding occur and performance glands back to back. Reported in the literature, 25% ~ 72% of the villous adenoma malignant transformation occurs, the transfer of about 12%.
(3) the special nature of gastric polyps ① hamartomatous polyps; clinical hamartomatous polyps can exist alone, but also with mucocutaneous pigmentation and gastrointestinal polyposis (peutz-jegher syndrome) co-exist. Are not accompanied by intestinal polyposis hamartomatous gastric polyps, gastric acid secretion confined to the upper stomach area, and diameter of sessile polyps of less than 5cm. In the pj syndrome, polyps larger and can be pedunculated and lobulated. Histologically hamartomatous polyps have a normal component of the irregular mucosa mature growth, mucus cell hyperplasia, mixed with parietal cells and chief cells. Crypt was cystic expansion. Smooth muscle fiber bundles from the muscularis mucosa upward radial, the normal gastric glands into lobules. Of mild interstitial edema and hyperemia. Small hamartomatous polyps in endoscopic biopsy of visible integrity. While the larger polyp biopsy can be seen only on the surface and crypt hyperplasia of the epithelium. ② atopic polyps; mainly by ectopic pancreas or brunner gland composition, are also included in the hamartomatous polyps range.