Pathologic Classification and Evaluation of Gastric Benign Polypoid Lesions on Endoscopy / 대한소화기내시경학회지

ABSTRACT

BACKGROUND/AIMS: The detection rate of the gastric polyp tends to be increased according to development of endoscopic biopsy or polypectomy. However, some of the endoscopically polypoid lesions are not true polyps, and these lesions actually show non-specific finding. Therefore, it is necessary to classify gastric polypoid lesion on endoscopy. METHODS: For investigation of gastric benign polypoid lesions on endoscopy, we reviewed 544 gastric polypoid leisons and classified accordi.ng to Snover's criteria, from 1994 to 1996 of Soonchunhyang University Hospital. RESULT: 1. Among 544 gastric polypoid lesions, 440 cases(81%) of epithelial lesions, 78 cases(14%) of nonspecific polypoid lesions, and 26 cases(5%) of submucosal tumors and were noted. The epithelial lesions consisted of neoplastic polyps(21%), hyperplastic polyps(53%), and limited hyperplasia(26%). Nonspecific polypiod lesions consisted of 29 cases of hypertrophy of muscularis mucosa, 24 cases of lymphoid hyperplasia, 16 cases of edema of lamina propria, 7 cases of submucosal edema and fibrosis, and 2 cases of submucosal lymphangiectasia. Submucosal tumors consisted of 9 cases of stromal tumor, 8 cases of ectopic pancreas, 5 cases of inflammatory fibroid polyp, 2 cases of xanthoma, 1 case of lipoma, and 1 acse of lymphangioma. 2. The size over 0.5 cm in neoplastic polyp and hyperplastic polyp occupied 48.4%, and 32.2% respectively. And the size under 0.2 cm in limited hyperplasia occupied 72% of total cases. The distribution of Yamada type of polypoid leisons revealed type II predominancy in neoplastic polyps(46.2%), even distribution in hypeplastic polyps(I; 65, II; 77, III; 78 cases), and type I predominancy in limited hyperplasia(64.9%). The distribution of the localization of the polypoid lesion disclosed antrum predominancy in neoplastic polyps(50.5%) and hyperplastic polyps(38.6). CONCLUSIONS: Benign gastric polypoid leisons on endoscopy were not only neoplastic and hyperplastic polyps, but also limited regenerative hyperplasia of epithelium and submucosal nonspecific inflammation and fibrosis, which tended to be smaller in size than neoplastic and hyperplastic polyp and belonged to Yamada type I or II.