Giant hyperplastic gastric polyp: A diagnostic dilemma!!

Gastric hyperplastic polyps (GHP) account for a majority of benign gastric polyps. Most of the GHPs are <2 cm, asymptomatic, and incidentally detected on endoscopy or radiologically. With increasing size, these polyps manifest as upper gastrointestinal bleeding, iron deficiency anemia, and gastric outlet obstruction (GOO). We report an unusual case of giant GHP simulating gastric carcinoma and posing as a diagnostic challenge for the surgeons emphasizing the diagnostic role of histopathology. A 46-year-old female presented with clinical features of progressive GOO for 1 year. Endoscopy revealed an eccentric proliferative lesion in the antrum. Computed tomography showed a polypoidal, enhancing mural thickening involving distal body and antro-pyloric region measuring 8.4 cm × 6.6 cm × 1.8 cm. Subtotal gastrectomy was done in view of clinical features of GOO and having a clinical suspicion of malignancy. Gross examination showed a giant sessile hyperplastic polyp with lobulated surface. Microscopy revealed features of a large, sessile hyperplastic polyp without any evidence of dysplasia. The patient was symptomatically relieved and is on follow-up. To conclude, giant GHPs can mimic gastric carcinoma on endoscopy and radiology. The possibility of giant GHP should be kept in mind in the presence of an intensely contrast-enhancing polypoidal lesion in the gastric antrum. Long-term endoscopic follow-up is recommended.

A Rare Case of Lymph Node Metastasis from Early Gastric Cancer

Gastric cancers that fulfill the Japanese criteria for curative endoscopic resection show a low risk of lymph node (LN) metastasis. Here, we report a case of LN metastasis from early gastric cancer that fulfilled the curative criteria. A 74-year-old Japanese woman was referred to our hospital for treatment of early gastric cancer identified at the site of a hyperplastic polyp that had been diagnosed 10 years prior to presentation. Contrast-enhanced computed tomography did not show any lymphadenopathy and laparoscopy-assisted distal gastrectomy was performed. Histopathological examination revealed a predominantly moderately differentiated adenocarcinoma that measured 15 mm in size and was confined to the mucosa. However, a single metastatic regional LN was observed. A few cancer cells showed positive staining for alpha-fetoprotein. It should be noted that early gastric cancer can be accompanied by LN metastasis even if it fulfills the criteria for curative endoscopic resection.

Analysis of serum gastric function and Helicobacter pylori infection in patients with gastric hyperplastic polyps and gastric fundic gland polyps / 中国综合临床

Objective To analyze the serum gastric function and Helicobacter pylori ( HP ) infection in patients with gastric hyperplastic polyps and gastric fundic gland polyps.Methods From December 2017 to December 2018, 135 patients with gastric polyps and pathologically confirmed gastric hyperplastic polyps and gastric fundic gland polyps were enrolled in the hospital of Xuzhou Medical University.Among them, 68 patients with hyperplastic polyps, 67 cases of the gastric fundic gland polyps.Serum Hp antibodies ( UreA, UreB, VacA, CagA antibodies ) were qualitatively detected by immunoblotting.Eighty patients with chronic superficial gastritis were selected as the control group.Three groups of serum pepsinogen?I ( PG?I),pepsinogen?Ⅱ( PG?Ⅱ),gastrin were detected by enzyme?linked immunosorbent assay (ELISA).Gastrin?17( G?17) and calculate PGⅠ and PGⅡ ratio( PGR).Results The levels of serum PGⅡ(13.13(8.15,20.30) μg ／L) and G17 (8.44(3.72,27.17) pmol／L) in the gastric hyperplastic polyp group were higher than those in the control group (9.16(5.56,15.14) μg／L and 1.83(0.87,5.95) pmol／L) ( P＜0.05),and the PGR level was lower than the control group ( P＜0.05);serum PGI ( 120.12 ( 86.72,174.70) μg／L), PGII ( 11.92 ( 7.27,22.26) μg／L),G17 ( 5.68 ( 1.79, 14.65) pmol／L) in the gastric fundic gland polyp group was higher than the control group (( 101.32 (79.17,131.33) μg ／L,9.16 ( 5.56,15.14) μg ／L,1.83 ( 0.87,5.95) pmol／L) ( P 均＜0.05)) ( P＜0.05); serum G17 (8.44(3.72,27.17) pmol／L) level in gastric hyperplastic polyp group was higher than gastric fundus polyp group (5.68(1.79,14.65) pmol／L) ( P＜0.05); Hp infection rate in gastric hyperplastic polyp group61.76%(42／68)was higher than that in the gastric fundic gland polyp group40.30%(27／67) (P＜0.05),and type I Hp was the main one (P＜0.05).The serum PGⅡ and G17 levels in the gastric hyperplastic polyp group were higher than those of Hp negative ( all P＜0.05).There were no significant differences in serum PGI, PGⅡ, G17, and PGR levels between the HP?positive and negative?positive patients in the gastric fundus polyp group.The serum PGI and PGR levels in the hypertrophic polyp group were higher than those in the HPⅡ type ( all P＜0.05).There was no significant difference in the levels of serum PGⅠ,PGⅡ,G17,and PGR between the gastric fundic gland polyps group and the type Ⅱ.Conclusion Serum PG and G17 levels in patients with gastric hypertrophic polyps and gastric fundic gland polyps are higher than those in patients with chronic superficial gastritis.Patients with gastric hyperplastic polyps have higher HP infection rate and abnormal gastric function than gastric fundic gland polyps.

Serrated neoplasia pathway as an alternative route of colorectal cancer carcinogenesis

In the past two decades, besides conventional adenoma pathway, a subset of colonic lesions, including hyperplastic polyps, sessile serrated adenoma/polyps, and traditional serrated adenomas have been suggested as precancerous lesions via the alternative serrated neoplasia pathway. Major molecular alterations of sessile serrated neoplasia include BRAF mutation, high CpG island methylator phenotype, and escape of cellular senescence and progression via methylation of tumor suppressor genes or mismatch repair genes. With increasing information of the morphologic and molecular features of serrated lesions, one major challenge is how to reflect this knowledge in clinical practice, such as pathologic and endoscopic diagnosis, and guidelines for treatment and surveillance.

Diagnostic value of white light endoscopy and narrow band imaging for colorectal sessile serrated adenoma and hyperplastic polyp / 中华消化内镜杂志

Objective To differentiate colorectal sessile serrated adenoma(SSA)and large hyperplastic polyp(HP)with white light endoscopy and narrow band imaging. Methods Retrospective analysis was performed on the clinical data of 953 patients who underwent endoscopic screening for colorectal cancer at digestive endoscopy center of Peking Union Medical College Hospital from January 2015 to December 2015.Endoscopic features were compared with white light endoscopy and narrow band imaging between SSA and large HP in location, size, Paris classification, surface mucus, NICE classification and varicose microvascular vessel(VMV). Results A total of 28(2.9%)SSAs and 25(2.6%)HPs of diameter not less than 0.5 cm were detected in the total of 953 patients.Statistically significant difference was found in right hemi-colon, diameter not less than 1.0 cm and VMV in two groups(P<0.05). The sensitivities of the above three markers for SSA were 89.3%, 67.9% and 46.4% respectively. The specificities were 64.0%,76.0% and 84.0% respectively. Diagnostic accuracies were 77.4%,71.7% and 64.2% respectively. And the sensitivity, specificity and accuracy of three markers combined(at least two markers)were 75.0%, 88.0% and 81.1%, respectively. Conclusion SSA and large HP could be differentiated with a systemic consideration of lesion location, size, and surface of microvessels by using white light endoscopy and image-enhanced technique.

Morphological features of colorectal sessile serrated adenoma/polyp under white light endoscopy and narrow band imaging / 中国内镜杂志

Objective To investigate the morphological features of colorectal sessile serrated adenoma/polyp (SSA/P) by white light endoscopy (WLE) and narrow band imaging (NBI). Methods A retrospective analysis was made on the morphological characteristics of SSA/P from January 2014 to March 2017, and compared with HP. Results There were 50 cases of SSA/P from 41 patients and 50 cases of HP from 43 patients. SSA/P located in the right colon was more than HP, but the difference was no statistical significance (16 cases vs 14 cases,P > 0.05). SSA/P have 11 cases of Type Is, 21 cases of Type IIa, 16 cases of Type IIb, 2 cases of Type LST, HP have 17 cases of Type Is, 25 cases of Type IIa, 8 cases of Type IIb, there was no significant difference (P > 0.05); SSA/P has more mucus than HP (37 cases vs 11 cases, P < 0.05). In NBI: The proportion of SSA/P with a red mucus cap, indistinctive borders, irregular shape, black dots inside the crypts, Cloud-like surface, Type II-O pit pattern and varicose microvascular vessels were higher than that of HP (P < 0.05). In the differential prediction of SSA/P and HP: Black dots inside the crypts (OR

Inverted Hyperplastic Polyp in Stomach: A Case Report and Literature Review / 대한소화기학회지

An inverted hyperplastic polyp (IHP) found in stomach is rare and characterized by downward growth of hyperplastic mucosal component into the submucosa. Because of such characteristic, IHP can be misdiagnosed as subepithelial tumor or malignant tumor. In fact, adenocarcinoma was reported to have coexisted with gastric IHP in several previous reports. Because only 18 cases on gastric IHP have been reported in English and Korean literature until now, pathogenesis and clinical features of gastric IHP and correlation with adenocarcinoma have not been clearly established. Herein, we report a case of gastric IHP which was initially misdiagnosed as gastrointestinal stromal tumor and resected using endoscopic submucosal dissection. Literature review of previously published case reports on gastric IHP is also presented.

A case report of pyloric intussusception secondary to helicobacter pylori hyperplastic polyps

We report a middle age man who presented with intermittent vomiting and loss of weight. Oesophagogastroduodenoscopy showed numerous antral hyperplastic polyps with inaccessible duodenum. Contrast enhanced computed topography demonstrated a classical target sign of intussusception. This finding was later confirmed at laparotomy. This rare presentation and management strategy is discussed.

Pachydermoperiostosis Associated with Peptic Ulcer and Hyperplastic Polyp of Stomach / 대한피부과학회지

No abstract available.

Hemorragia digestiva alta causada por pólipo gástrico hiperplásico: relato de caso / Upper gastrointestinal haemorrhage caused by hyperplastic polyp: case report

Conceitualmente, hemorragia digestiva alta (EDA) é definida como qualquer sangramento de localização proximal ao ângulo de Treitz na prática originária do esôfago, estômago e duodeno. Apesar dos avanços, tanto na área diagnóstica quanto terapêutica, a hemorragia digestiva continua sendo uma importante causa de morbimortalidade, com alta incidência e de grande impacto econômico. Mesmo com novas técnicas endoscópicas, a mortalidade permanece elevada com o passar dos anos. No presente artigo, relatamos o caso de uma paciente de 80 anos de idade que deu entrada em nosso serviço, referindo 2 episódios de hematêmeses nas 12 horas que antecederam à admissão hospitalar. Após estabilização hemodinâmica, foi submetida à EDA que revelou grande pólipo gástrico, sem sinais de sangramento ativo. Optou-se por terapia mecânica hemostática combinada (endoloop e hemoclips), com sucesso. Porém houve ressangramento da lesão, com instabilidade hemodinâmica, e a segunda tentativa de hemostasia mecânica foi associada à correção do INR com plasma, já que a paciente fazia uso crônico de warfarin devido à fibrilação atrial crônica. Paciente evoluiu bem, tendo alta após 3 dias da segunda abordagem endoscópica. Estudos recentes evidenciam que a terapia combinada é mais efetiva do que a monoterapia no controle das hemorragias digestivas altas. No presente caso, optamos por dois métodos mecânicos, com êxito somente após a segunda abordagem. Neste caso, a coagulopatia foi o principal fator predisponente na ocorrência do ressagramento. Portanto sempre se deve atentar para sua correção em casos em que se acredite que a alteração possa influenciar negativamente no prognóstico.

Conceptually, upper gastrointestinal bleeding is defined as any bleeding located proximal to the angle of Treitz, originating from the esophagus, stomach and duodenum. Despite advances in the diagnostic and therapeutic methods, gastrointestinal bleeding remains a important cause of morbidity and mortality, with high incidence and economic impact. Even with new endoscopic techniques, mortality remains high over the years. In this article, we report a case of a 80-year-old woman who was admitted in our hospital, referring 2 episodes of hematemeses, 12 hrs before the admission. After hemodynamic stabilization, we submit de patient to a EGD that revealed a large gastric polyp with no signs of active bleeding. We chose a combined therapy, mechanical and haemostatic (end loop and hem clips), successfully. But after this, there was rebreeding, hemodynamic instability, and a second attempt was tried. In the second approach we associated mechanical therapy to correction of INR with plasma, since the patient had chronic use of warfare due to chronic atria fibrillation. Patient recovered well and was discharged three days after the second endoscopic approach. Recent studies show that combined therapy is more effective than monoterapia in controlling high digestive bleeding. In this case we chose two mechanical methods, successfully only after the second approach. In this case the coagulopathy was the main predisposing factor in the rebleeding occurrence. Therefore we must always be attentive to its correction in cases where we believe that it can negatively influence the prognosis.

Adenocarcinoma Occurring in a Gastric Hyperplastic Polyp Treated with Endoscopic Submucosal Dissection

Gastric hyperplastic polyps are generally considered benign lesions, although rare cases of adenocarcinoma have been reported. Although, the underlying mechanism of carcinogenesis in gastric hyperplastic polyps is still uncertain, most malignant polyps are seen to originate from dysplastic epithelium rather than from hyperplastic epithelium. Herein, we report the case of a woman diagnosed with adenocarcinoma that originated from a hyperplastic gastric polyp that was successfully removed by endoscopic submucosal dissection. In this case, we observed adenomatous changes around the cancerous component.

A Case of Gastric Inverted Hyperplastic Polyp Found with Gastritis Cystica Profunda and Early Gastric Cancer

A gastric inverted hyperplastic polyp is a rare type of gastric polyp and is characterized by downward growth of a variety of mucosal components into the submucosa. The polyp consists of columnar cells resembling foveolar epithelium and pyloric gland epithelium and can coexist with gastritis cystica profunda. Frequently, adenocarcinoma can coexist, but the relation is not clear. A 77-year-old male underwent endoscopic submucosal dissection due to early gastric cancer. A gastric inverted hyperplastic polyp was found in the removed specimen and gastric cystica profunda was also found. We report a case of gastric inverted hyperplastic polyp coexisting with gastric cystica profunda and gastric adenocarcinoma.

A Case of Mixed Hyperplastic-adenomatous Rectal Polyp with Composition of Invasive Adenocarcinoma

Epithelial colon polyps are largely divided into hyperplastic and adenomatous polyps. Adenomatous polyps are premalignant lesions, whereas hyperplastic polyps are regarded as benign lesions. However, this histological classification has been blurred, as cases of malignant changes in hyperplastic polyposis, mixed hyperplastic adenomatous polyps (MHAPs), and serrated adenomas in the colon have been reported. Rare cases of MHAP have been reported, and are mainly found at the proximal colon with a relatively large size. MHAPs seem to be an intermediate stage of the hyperplastic polyp-adenoma sequence or a collision tumor. Here, we report on a case of a single polyp in the rectum diagnosed with a MHAP combined with an invasive adenocarcinoma.

Sessile Serrated Adenoma with High-grade Dysplasia / 이화의대지

Until recently, colorectal polyps were classified predominantly as hyperplastic or adenomatous. While adenomatous polyps are well-characterized precursor lesions of adenocarcinomas, hyperplastic polyps have been considered as benign lesion. However, some hyperplastic polyps with serrated morphology of the crypts have been recognized to have distinctive features and these polyps were termed 'serrated adenomas'. Recent data show that sessile serrated adenomas (SSA) might be the precursors of serrated colonic cancers, underlining the necessity of identifying them. SSA is approximately 3% of all polyps, commonly appears as flat or sessile and yellowish due to mucus production. In the pathogenesis of SSA, progression to high grade dysplasia or early invasive carcinoma may be associated with serrated neoplasia pathway different from adenoma-carcinoma sequence. We report a case with a colon polyp diagnosed as sessile serrated adenoma with high grade dysplasia after endoscopic submucosal dissection.

Multifocal Adenocarcinomas Arising within a Gastric Inverted Hyperplastic Polyp

We present herein the occurrence of multifocal adenocarcinomas with a minute signet ring cell carcinoma that arose within a gastric inverted hyperplastic polyp (IHP) in a 40-year-old woman. Endoscopic ultrasonography demonstrated a heterogeneous hypoechoic mass in the third layer of the gastric wall. The endoscopic submucosal dissection specimen measuring 3.5x3.2x1.8 cm was a well-circumscribed protruding lesion that had a slit-shaped cavity. Histologically, the lesion consisted mainly of endophytic proliferation of hyperplastic columnar cells resembling normal foveolar epithelium. In addition, six foci of adenocarcinomas and a minute focus of signet ring cell carcinoma were randomly distributed in the superficial and deep regions. The adenocarcinoma was gradually transitioning from dysplasia, while the signet ring cell carcinoma was surrounded by hyperplastic foveolar epithelium. This is the first report of a gastric IHP with multifocal intramucosal adenocarcinomas and a signet ring cell carcinoma, and endoscopic submucosal dissection is used to completely resect it.

A Case of Signet Ring Cell Carcinoma with Hyperplastic Polyp in the Remnant Stomach after Subtotal Gastrectomy / 대한소화기내시경학회지

Hyperplastic polyps are usually found in the stomach and they account for 50 to 90% of all gastric epithelial polyps. In contrast to the adenomatous polyps, it has been reported that most hyperplastic polyps are benign. However, in rare cases hyperplastic polyps have revealed carcinoma, and the incidence of malignant changes is generally recognized to be about 1 to 3%. Most of the reported cases of a hyperplastic gastric polyp with a transformation to adenocarcinoma were well differentiated histopathologically. Herein we report on an extremely rare case that involved the association of a hyperplastic polyp and focal signet ring cell carcinoma in the remnant stomach after subtotoal gastrectomy.

To the problem of colorectal cancer and its pathological diagnose / Монголын Анагаах Ухаан

BackgroundColorectal cancer takes the second place in the highly developed countries morbidity increases, for females it takes place after breast cancer, for males after lung cancer colorectal cancer occupies about 3-5% from the cancer of digestive tract. In the western Europe, united states of America it occuries 12.6% on males and 14% on females, for Pathological structure it occurs mostly in the proximal part and adenocarcinoma is diagnosed 95%. Colorectal carcinoma occurs more at the age of 20-40 but people aged 40-50 are mostly affected and males are affected more. Lately it has tendency of increasing amond the population 40-120 case on 100000 in a year approximately 5-10 people are affected newly. For our country by health statistical information colon cancer was 94 from it 49 occur on females, cancer of rectal and anus canal was 237, from it 99 occur on females, 37 case of colorectal cancer are registered newly in a year approximately, 19 occurs on females cancer of rectal and anus canal was 45 from them 16 are registered newly on females the number of patients with colorectal cancer has tendency of increasing. Among Mongolian population morbidity of colorectal cancer is increasing nowadays but any research has not been done to reveal pathology early and to diagnose. This became base of our research work.GoalAim of our study is to define peculiarity of colorectal cancer and its early pathology and to study some factor of aetiology connectea with cancer forming.Objectives:1. To define peculiarity of pathology of colorectal cancer.2. To diagnose early pathology of colorectal cancer by pathological method.3. To diagnose colorectal carcinoma by international histological classification and determine cell secretion degree.4. To define some genetic peculiarity of factors which affects to colorectal carcinoma.Novelty of research workNovelty of research work is to study colorectal carcinoma and its early pathology in combination with the method of endoscopy and molecular biology.Materials and MethodsIn the research 315 biopsy material of 142 patients with colorectal carcinoma of 2004-2008, 56 biopsy material of colorectal endoscopy of 2007-2008 are involved.1. Histological basic painting method.2. Method of molecular biology. We revealed affect of human papilloma virus infection in 39 surgical and endoscopyic material by using general GP5, GP6, MY11 primer in PSR.ResultsIn our study totally 198 people were involved from them (average age 45.8+ - 0.4), 46.0%(n=91)-male, 54% (n=107) female. If we see people involved in the study by age classification, 8 (5.9%) at the age of 20-29, 21 (10.3%) at the age of 30-39, 39 (19.3%) at the age of 40-49,45 (22.4%) at the age of 50-59, 56 (27.7%) at the age of 60-69, over 70-79 (14.3%). If we see colorectal carcinoma by anatomical location most location was in 45 (22.7%) in sigma, 52 (26.2%) in rectus. Seeing from endoscopic biopsy analyse pathology which involved whole colorectus occupied 10 (35.6%). By international histological classification of cancer which was adopted from WHO. In our study polyp occupies 21 (10.6%), adenoma 24(12.1%), adenocarcinoma 137 (69.2%), metastatic carcinoma 6 (3%), chronic inflammation or with change dysplasia 10 (5.1%). If we see endoscopic biopsy analyse it is 56 (28.3%) of people involved in the research. Hyper plastic polyp 21 (36.1%), adenoma 6 (25%), adenomatous polyp 8 (33.3%) occupces, Tubular adenoma polyp 7 (29.2%), villous adenoma 3 (12.5%) from carcinoma adenomatous carcinoma occupces 98 (71.5%), mucous carcinoma 7 (5.1%), carcinoma with flat cell 8 (5.8%), carcinoma with ring cell 5 (5.1%), carcinoma witout secretion 13 (9.5%), carcinoma with metastases 6 (4.3%), one of factors of etiology which affects to colorectal carcinoma is human papilloma virus. In the biopsy material of surgery and endoscope involved in the research it reveals negative in sensitive primer which reveals all the type of papilloma virus.Conclusions:1. Colorectal carcinoma occurs 19.3% at the age of 40-49, 22.4% at the age of 50-59, 27.7% at the age of 60-69, it has tendency of increasing rohen age becomes older. It occurs 14% over 70.2. By location of anatomy colorectal carcinoma it occupies 50-60% in sigma and rectus.3. Noncarcinomous polyp of colorectal carcinoma is situated in many parts of intestine carcinoma with many polyp occupies 35.6%of total carcinoma.4. By histological classification mostly carcinomous and noncarcinomous carcinoma of epithel and adenomous cell originated occupy.5. Papilloma virus hasn’t been releaved in the sample endoscopic sample.

A Significant Number of Sessile Serrated Adenomas Might Not Be Accurately Diagnosed in Daily Practice

BACKGROUND/AIMS: The diagnosis of hyperplastic polyps (HPs) may involve a conglomeration of subgroups of serrated polyps. The diagnosis of HPs may therefore be revisited if this is sessile serrated adenoma (SSA). The aim of this study was to determine clinically and endoscopically relevant information associated with reclassification to SSA. METHODS: After reviewing the data from 1,372 patients who underwent colonoscopic polypectomy, 49 HPs larger than 10 mm were analyzed in this study. Two gastrointestinal pathologists reclassified each of the original 49 HPs as conventional HPs, SSAs, and others. RESULTS: Among the 49 initially diagnosed HPs, 18.4% were reclassified into SSAs or mixed polyps. Overall architectural features were useful for the diagnosis of SSA, but cytological features were less useful. The patient and polyp characteristics did not differ between HPs with and without reclassification of the initial pathological diagnosis. CONCLUSIONS: A significant number of SSAs might not be accurately diagnosed in daily clinical practice without any predilection for size, shape, and location. Therefore, when large HPs are diagnosed in clinical practice, it is necessary for physicians to have greater awareness of the diagnosis of SSA and to individualize subsequent surveillance.

The clinical significance on typing of hyperplastic gastric pits / 中国基层医药

Objective To explore the clinical significance of gastric hyperplastic polyp pits under magnifying endoscopy. Methods Summary confirmed by magnifying endoscopy and pathological examination gastric hyperplastic po]yp's performance of magnifying endoscopy,Hp positive and the results of pathology during February 2004 to De-cember 2006. Results 55 patients found 116 gastric polyp,41.4% (48/116) with type A,26.7% (31/116) with type B,19. 8% (23/116) with type C,8. 6% (10/116) with type D,2. 6% (3/116) with type E,one case gastric pits blurred(type F) 0. 9% (1/116). 4 cases with type E and type F found moderate-severe atypical hyperplasia. Conclu-sion Gastric hyperplastic polyp pits with type E and type F ,their results of pathology to display atypical hyperplasia.

The Clinicopathological Features of Gastric Hyperplastic Polyps with Neoplastic Transformations: A Suggestion of Indication for Endoscopic Polypectomy

BACKGROUND/AIMS: Although gastric hyperplastic polyps are usually considered as benign lesions, a low risk of carcinomatous conversion is currently recognized. We aimed to identify the characteristics of hyperplastic polyps undergoing neoplastic transformation. METHODS: A total of 269 gastric hyperplastic polyps from 216 patients removed by endoscopic polypectomy (EP) or surgical resection were enrolled in this study, and their endoscopic pictures and pathology slides were reviewed. RESULTS: Neoplastic transformation was detected on forceps biopsy specimen in 11 cases. However, the pathology findings from the EP or surgical specimen revealed neoplastic transformation in 14 cases (5.2%; 4 with dysplasia and 10 with adenocarcinoma). No significant difference was found between hyperplastic polyps with and without neoplastic transformation in age, sex, location, number of polyps or gross appearance. However, neoplastic transformations were more frequently found in gastric hyperplastic polyps >1 cm than in polyps 1 cm. Therefore, EP should be considered for gastric hyperplastic polyps >1 cm for the accurate diagnosis and definitive treatment.