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Two rare gastric hamartomatous inverted polyp cases suggest the pathogenesis of growth 被引量:8

Two rare gastric hamartomatous inverted polyp cases suggest the pathogenesis of growth
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摘要 Gastric hamartomatous inverted polyps(GHIP)are difficult to diagnose accurately because of inversion into the submucosal layer.GHIP are diagnosed using the pathological characteristics of the tumor,including the fibroblast cells,smooth muscle,nerve components,glandular hyperplasia,and cystic gland dilatation.Although Peutz-Jeghers syndrome,juvenile polyposis,and Cowden disease are hereditary,it is rare to encounter 2 cases of monostotic and asymptomatic gastric hamartomas.The pathogeneses of hamartomatous inverted polyps and inverted hyperplastic polyps remain controversial because of the paucity of reported cases.There are 3 hypotheses regarding the pathogenesis of complete gastric inverted polyps.Based on our experience with 2 successive,rare GHIP cases,we affirm the hypothesis that after a hamartomatous change occurs in the submucosal layer,some of these components are exposed to the gastric mucosa and,consequently,form a hypertrophic lesion.In Case 1,our hypothesis explains why a tiny hypertrophic change was first detected on the top of the submucosal tumor using a detailed narrow band imaging-magnified endoscopy.There was no confirmation that the milky white mucous and calcification structures were exuding directly from the biopsy site like Case 1,and in Case 2 the presence of this mucous was indirectly confirmed during an endoscopic submucosal dissection(ESD).Regarding the pathogenesis of GHIP,a submucosal hamartomatous change may occur prior to the growth of hypertrophic portions.An en bloc resection using ESD is recommended for treatment. Gastric hamartomatous inverted polyps (GHIP) are difficult to diagnose accurately because of inversion into the submucosal layer. GHIP are diagnosed using the pathological characteristics of the tumor, including the fibroblast cells, smooth muscle, nerve components, glandular hyperplasia, and cystic gland dilatation. Although Peutz-Jeghers syndrome, juvenile polyposis, and Cowden disease are hereditary, it is rare to encounter 2 cases of monostotic and asymptomatic gastric hamartomas. The pathogeneses of hamartomatous inverted polyps and inverted hyperplastic polyps remain controversial because of the paucity of reported cases. There are 3 hypotheses regarding the pathogenesis of complete gastric inverted polyps. Based on our experience with 2 successive, rare GHIP cases, we affirm the hypothesis that after a hamartomatous change occurs in the submucosal layer, some of these components are exposed to the gastric mucosa and, consequently, form a hypertrophic lesion. In Case 1, our hypothesis explains why a tiny hypertrophic change was first detected on the top of the submucosal tumor using a detailed narrow band imaging-magnified endoscopy. There was no confirmation that the milky white mucous and calcification structures were exuding directly from the biopsy site like Case 1, and in Case 2 the presence of this mucous was indirectly confirmed during an endoscopic submucosal dissection (ESD). Regarding the pathogenesis of GHIP, a submucosal hamartomatous change may occur prior to the growth of hypertrophic portions. An en bloc resection using ESD is recommended for treatment.
出处 《World Journal of Gastroenterology》 SCIE CAS 2014年第19期5918-5923,共6页 世界胃肠病学杂志(英文版)
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参考文献6

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同被引文献26

  • 1Vui Heng Chong.Clinical significance of heterotopic gastric mucosal patch of the proximal esophagus[J].World Journal of Gastroenterology,2013,19(3):331-338. 被引量:19
  • 2Masahiko Aoki,Masashi Yoshida,Yoshiro Saikawa,Yoshihide Otani,Tetsuro Kubota,Koichiro Kumai,Go Wakabayashi,Tai Omori,Makio Mukai,Masaki Kitajima.Diagnosis and Treatment of a Gastric Hamartomatous Inverted Polyp: Report of a Case[J].Surgery Today.2004(6)
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  • 6Matsuoka J,Itaba S,Makihara Y,Murao H,Umeno N,Minoda Y,Kaku T,Kuniyoshi M,Hamada T,Nakamura K.(Three cases of pedunculated gastric hamartomatous inverted polyps resected endoscopically)Nihon Shokakibyo Gakkai Zasshi . 2015
  • 7Miyamoto Y,Muguruma N,Okamura S,Okada Y,Kitamura S,Okamoto K,Yoneda A,Kagawa N,Takayama T.A pedunculated submucosal lesion in the stomach with inverted downgrowth. Journal of Internal Medicine . 2014
  • 8Odashima M,Otaka M,Nanjo H,Jin M,Horikawa Y,Matsuhashi T,Ohba R,Koizumi S,Kinoshita N,Takahashi T,Shima H,Watanabe S.Hamartomatous inverted polyp successfully treated by endoscopic submucosal dissection. Journal of Internal Medicine . 2008
  • 9Minsun Jung,Kyueng-Whan Min,Young-Joon Ryu.??Gastric Inverted Hyperplasic Polyp Composed Only of Pyloric Glands(J)International Journal of Surgical Pathology . 2015 (4)
  • 10Tokuyuki Kono,Yasuo Imai,Takao Ichihara,Kasumi Miyagawa,Kiyonori Kanemitsu,Tetsuo Ajiki,Kentaro Kawasaki,Takashi Kamigaki,Hajime Ikuta,Chiho Ohbayashi,Hiroshi Yokozaki,Takahiro Fujimori,Yoshikazu Kuroda.??Adenocarcinoma arising in gastric inverted hyperplastic polyp: A case report and review of the literature(J)Pathology - Research and Practice . 2006 (1)

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