In Search of Nodular Gastric Antral Vascular Ectasia: A Distinct Entity or Simply Hyperplastic Polyps Arising in Gastric Antral Vascular Ectasia?

Autor: Sanchez-Avila M; From the Departments of Laboratory Medicine and Pathology (Sanchez-Avila, Chauhan, Amin, Snover)., Amin K; From the Departments of Laboratory Medicine and Pathology (Sanchez-Avila, Chauhan, Amin, Snover)., Chauhan A; From the Departments of Laboratory Medicine and Pathology (Sanchez-Avila, Chauhan, Amin, Snover)., Geng Z; Gastroenterology (Geng, Mallery), University of Minnesota, Minneapolis., Mallery S; Gastroenterology (Geng, Mallery), University of Minnesota, Minneapolis., Snover DC; From the Departments of Laboratory Medicine and Pathology (Sanchez-Avila, Chauhan, Amin, Snover).
Jazyk: angličtina
Zdroj: Archives of pathology & laboratory medicine [Arch Pathol Lab Med] 2024 Jan 01; Vol. 148 (1), pp. 55-60.
DOI: 10.5858/arpa.2022-0230-OA
Abstrakt: Context.—: Nodular gastric antral vascular ectasia (GAVE) is a reported phenotype of GAVE that has histologic features overlapping with gastric hyperplastic polyps (GHPs), with additional features often seen in flat mucosa of GAVE.
Objective.—: To determine if nodular GAVE and GHPs are distinct lesions by evaluating the prevalence of features reported in nodular GAVE in GHPs with or without associated GAVE.
Design.—: A review of all lesions diagnosed as GHPs between 2014 and 2017 was performed. Slides were analyzed for a number of features including established histologic features of GAVE without knowledge of clinical or endoscopic features.
Results.—: A total of 90 polyps were analyzed including 18 from patients with GAVE (20%). GAVE polyps were larger than non-GAVE polyps (average size, 1.3 cm versus 0.68 cm; P < .001), with more common extensive ulceration and associated granulation tissue (61.11% [n = 11] versus 4.17% [n = 3]; P = .004), fibrin thrombi (50% [n = 9] versus 15% [n = 11]; P = .003), moderate to marked vascular ectasia (83% [n = 15] versus 35% [n = 11]; P = .001), and fibrohyalinosis (72% [n = 13] versus 28% [n = 20]; P = .001). All polyps showed foveolar hyperplasia and smooth muscle proliferation. There were no features that were exclusively found in GAVE or non-GAVE cases.
Conclusions.—: Nodular GAVE appears to represent GHPs arising in a background of GAVE, with superimposed features found in flat mucosa of GAVE stomachs. The presence of fibrin thrombi, marked vascular ectasia, fibrohyalinosis, and/or ulceration in a GHP is suggestive but not diagnostic of GAVE, and the absence of these features does not rule out GAVE.
(© 2024 College of American Pathologists.)
Databáze: MEDLINE
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