Division of Gastroenterology, University of British Columbia, and British Columbia Transplant Society, Vancouver, British Columbia, Canada.
Eur J Gastroenterol Hepatol. 2011 Nov;23(12):1245-9. doi: 10.1097/MEG.0b013e32834c15cf.
Gastric hyperplastic polyps are usually associated with chronic gastritis including Helicobacter pylori gastritis and postantrectomy stomachs. Here, we report on a series of 12 patients with portal hypertension secondary to liver cirrhosis, who were found to have a unique histological type of gastric polyp on endoscopy.
Retrospective chart review of 12 patients with portal hypertension, who presented with histologically diagnosed gastric hyperplastic polyps. These polyps were reviewed and compared with hyperplastic polyps from 21 patients who did not have portal hypertension.
The endoscopic appearances of portal hypertension-associated polyps varied considerably, with sizes ranging up to 18 mm. They were sessile or pedunculated, singular or multiple, found in the antrum or body of the stomach, and endoscopically appeared to be typical hyperplastic polyps. Histopathological examination, however, showed mucosal hyperplasia and extensive vascular proliferation and granulation tissue formation.
The unique histological appearance of gastric hyperplastic polyps in patients with portal hypertension polyps is described. The exact pathogenetic mechanism of polyp formation is unclear although it seems possible that the underlying cause is mucosal injury that is vascular in nature rather than being secondary to surface inflammation. Although there is an emerging evidence of the neoplastic potential of usual hyperplastic polyps, the natural history of portal hypertension-associated polyps is unknown. Identification and management of portal hypertension-associated gastric polyps present a particular dilemma, as these patients often have coagulopathies and vascular ectasias. Therefore, the natural history and endoscopic features of gastric polyps arising in portal hypertensive patients warrants further exploration.
增生性胃息肉通常与包括幽门螺杆菌胃炎和胃切除术后的慢性胃炎相关。在这里，我们报告了一系列 12 例因肝硬化导致门静脉高压的患者，他们在内镜下发现了一种独特的胃息肉组织学类型。
回顾性分析 12 例经组织学诊断为增生性胃息肉的门静脉高压患者的病历。对这些息肉进行了回顾性分析，并与 21 例无门静脉高压的增生性息肉患者的息肉进行了比较。
门静脉高压相关息肉的内镜表现差异很大，大小可达 18mm。它们是无蒂或有蒂的，单发或多发，位于胃窦或胃体，内镜下表现为典型的增生性息肉。然而，组织病理学检查显示黏膜增生、广泛的血管增生和肉芽组织形成。
描述了门静脉高压患者胃增生性息肉的独特组织学表现。虽然息肉形成的确切发病机制尚不清楚，但似乎可能是黏膜损伤，其性质是血管性的，而不是继发于表面炎症。尽管通常增生性息肉的肿瘤潜能有新的证据，但门静脉高压相关息肉的自然史尚不清楚。识别和处理门静脉高压相关胃息肉带来了特殊的困境，因为这些患者通常有凝血功能障碍和血管扩张。因此，门静脉高压患者胃息肉的自然史和内镜特征值得进一步探讨。
