High-grade dysplasia in sporadic fundic gland polyps: a case report and review of the literature

Eur J Gastroenterol Hepatol. 2003 Nov;15(11):1229-33. doi: 10.1097/00042737-200311000-00013.

Abstract

We present a case of fundic gland polyps (FGPs) containing high-grade dysplasia in a 68-year-old man. High-grade dysplasia, and even gastric adenocarcinoma, associated with FGPs have been described in patients with familial adenomatous polyposis (FAP) and attenuated familial adenomatous polyposis (AFAP) but never in non-FAP patients. Two colonoscopies in the past six years virtually rule out FAP and AFAP in our patient. Dysplasia in FGPs from non-FAP patients is extremely rare, and until now only cases of low-grade dysplasia have been described. The literature on dysplasia in FGPs is reviewed briefly. Additional immunohistochemical investigations in this case showed nuclear staining of beta-catenin, increased proliferation and apoptosis in the dysplastic areas of the FGPs. Our case suggests that the malignant potential of FGPs is not limited to FAP-associated FGPs.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Apoptosis
  • Carcinoma in Situ / complications
  • Carcinoma in Situ / pathology*
  • Cell Nucleus / chemistry
  • Cytoskeletal Proteins / analysis
  • Gastric Fundus
  • Humans
  • Immunohistochemistry / methods
  • Male
  • Polyps / complications
  • Polyps / pathology*
  • Stomach Neoplasms / complications
  • Stomach Neoplasms / pathology*
  • Trans-Activators / analysis
  • beta Catenin

Substances

  • CTNNB1 protein, human
  • Cytoskeletal Proteins
  • Trans-Activators
  • beta Catenin