Surgical Pathology Criteria

Fundic Gland Polyp

Differential Diagnosis

Small fundic gland polyps may be mistaken for normal gastric fundus

 

Fundic Gland Polyp Focal Foveolar Hyperplasia
Scant stroma, no inflammation Prominent edematous inflamed stroma
Cysts lined by parietal and chief cells Cysts lined my foveolar mucous cells
Increase in deep fundic glands forms the polyp Primarily elongation of pits

 

Fundic Gland Polyp Juvenile Polyposis
Scant stroma, no inflammation Prominent inflamed stroma
Cysts lined by parietal and chief cells Cysts lined by mucous cells
No association with polyps in the colorectum Most cases involve the colorectum
Same differential applies to the polyps of Cowden disease and Cronkhite-Canada syndrome

 

Fundic Gland Polyp Peutz-Jeghers Syndrome
Thin bundles of smooth muscle may surround cysts Arborizing muscle in polyps surrounds lobules of glands
Frequent cystic dilation Cystic dilation not prominent
No polyps in small intestine Most polyps in small intestine
Not familial Autosomal dominant
Beta-catenin or APC mutations LKB1/STK11 mutations in 50-90%

 

Fundic Gland Polyp Menetrier Disease
Increase in deep fundic glands forms the polyp Deep fundic glands are atrophic
Surface pits are shortened Foveolar hyperplasia forms the thickened mucosa

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