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Diagnosis of Neoplasia in Barrett’s Esophagus using Vital-dye Enhanced Fluorescence Imaging

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Morphologic characterization of syndromic gastric polyps.

Dora Lam-Himlin¹, Jason Y Park, Toby C Cornish

¹Department of Pathology, Johns Hopkins Hospital, Johns Hopkins University, Baltimore, MD 21231, USA.

The American Journal of Surgical Pathology

|October 7, 2010

Summary

Histologic diagnosis of gastric polyps in juvenile polyposis syndrome (JuvPS) and Peutz-Jeghers' Syndrome (PJS) is challenging. Even with developed criteria, distinguishing these from hyperplastic polyps (HP) remains unreliable, particularly for smaller or mixed-location polyps.

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Establishment and Characterization of Patient-derived Gastric Organoids from Biopsies of Benign Gastric Body and Antral Epithelium

Establishment and Characterization of Patient-derived Gastric Organoids from Biopsies of Benign Gastric Body and Antral Epithelium

Published on: January 26, 2024

Area of Science:

Gastroenterology
Pathology
Genetics

Background:

Gastric hamartomatous polyps in juvenile polyposis syndrome (JuvPS) and Peutz-Jeghers' Syndrome (PJS) lack detailed characterization.
Distinguishing these from common gastric hyperplastic polyps (HP) is clinically significant.

Purpose of the Study:

To investigate and define reliable histologic criteria for differentiating gastric polyps in JuvPS and PJS from HP polyps.
To assess the diagnostic accuracy of these criteria in a blinded setting.

Main Methods:

A panel of gastrointestinal pathologists reviewed gastric polyps from 26 JuvPS and 17 PJS patients, intermixed with 26 HP polyps.
Histologic features (epithelial changes, pit architecture, lamina propria, smooth muscle) were analyzed.
A two-phase blinded review process was employed, with and without clinical context.

Main Results:

Initial diagnostic accuracy was 50% for JuvPS, 18% for PJS, and 92% for HP polyps.
Adherence to developed criteria improved PJS accuracy to 54% but JuvPS remained low (41%).
Diagnostic accuracy was higher for larger polyps (≥10 mm) and specific mucosal locations (antrum, oxyntic).

Conclusions:

Histologic identification of gastric JuvPS and PJS polyps without clinical history is unreliable.
Developed morphologic criteria offer limited improvement, especially for JuvPS.
Accurate diagnosis of these syndromic polyps in the stomach remains a challenge compared to other gastrointestinal sites.