Fundic Gland Polyp
Differential Diagnosis
Small fundic gland polyps may be mistaken for normal gastric fundus
- Polypoid nature may not be evident
- Distortion of glands may not be evident
- Endoscopic description of fundic polyp(s) may suggest the diagnosis
- History of FAP or PPI should suggest the diagnosis
- Identification of even mild cystic dilation of deep glands lined by parietal and chief cells should permit the diagnosis
| 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 |
