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Presented by Ralph Hruban, M.D. and prepared by Lynette S. Nichols, M.D.
Case 2: This 40 year old woman has familial adenomatous polyposis and mild mental retardation.
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Question 1 of 1
1. Question
Week 99: Case 2
This 40 year old woman has familial adenomatous polyposis and mild mental retardation./images/Lyn’s/Hruban.2.a.jpg
/images/Lyn’s/Hruban.2.b.jpg
/images/Lyn’s/Hruban.2.c.jpgCorrect
Answer: Fundic gland polyp
Histology: This patient had a distal gastrectomy as a part of a duodenal resection for duodenal adenomas. Numerous mucosal polyps were present in the stomach, all showing dilated fundic glands.
Discussion: Fundic gland polyps are 1 to 5 mm mucosal polyps of the gastric body and fundus. Histologically they are characterized by the presence of cystically dilated fundic glands lined by an attenuated layer of chief and/or parietal cells. Fundic gland polyps can occur sporadically or they can arise in patients with familial adenomatous polyposis (FAP). Fundic gland polyps are the most common gastric polyps in patients with FAP, as well as in patients without FAP. Although 25% of FAP associated fundic gland polyps show surface epithelial dysplasia, these generally do not progress to an infiltrating carcinoma. Carcinoma arising from fundic gland polyps in the non-FAP setting has never been reported. Recently, Abraham et al. have shown that fundic gland polyps in FAP patients are genetically distinct from sporadic fundic gland polyps.
Incorrect
Answer: Fundic gland polyp
Histology: This patient had a distal gastrectomy as a part of a duodenal resection for duodenal adenomas. Numerous mucosal polyps were present in the stomach, all showing dilated fundic glands.
Discussion: Fundic gland polyps are 1 to 5 mm mucosal polyps of the gastric body and fundus. Histologically they are characterized by the presence of cystically dilated fundic glands lined by an attenuated layer of chief and/or parietal cells. Fundic gland polyps can occur sporadically or they can arise in patients with familial adenomatous polyposis (FAP). Fundic gland polyps are the most common gastric polyps in patients with FAP, as well as in patients without FAP. Although 25% of FAP associated fundic gland polyps show surface epithelial dysplasia, these generally do not progress to an infiltrating carcinoma. Carcinoma arising from fundic gland polyps in the non-FAP setting has never been reported. Recently, Abraham et al. have shown that fundic gland polyps in FAP patients are genetically distinct from sporadic fundic gland polyps.
