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Evaluation of clinico-pathological features and Helicobacter pylori infection in gastric inflammatory fibroid polyps
Andreia Albuquerque1, Elisabete Rios, Fátima Carneiro
1Department of Gastroenterology, Centro Hospitalar São João, 4200-319, Porto, Portugal, a.albuquerque.dias@gmail.com.
Abstract:
Inflammatory fibroid polyps are rare mesenchymal lesions. The frequency of Helicobacter pylori infection in the gastric mucosa overlying inflammatory fibroid polyps and its relation with the histologic features of the polyps are undetermined. The clinico-pathological features of inflammatory fibroid polyps, the frequency of Helicobacter pylori infection in the overlying gastric mucosa, and its putative impact on the phenotype of the polyps were evaluated. Gastric inflammatory fibroid polyps diagnosed in our Hospital from 1998 to 2012 were reviewed and the histological. The histological sections were stained with hematoxylin and eosin and modified Giemsa for the evaluation of Helicobacter pylori infection. Inconclusive cases were further analyzed by immunohistochemistry with anti-Helicobacter pylori antibody. Diagnosis was confirmed in 54 polyps, 85 % developed in females, mean age 63 ± 11 years. Most polyps were sessile (74 %), with a mean size of 15 ± 12 mm, 96 % were located in the antrum and 85 % were removed by snare polypectomy. Helicobacter pylori infection was identified in 48 % of the polyps. Most inflammatory fibroid polyps developed in the submucosa, and mucosal extension was observed in 96 % of the cases. Chronic gastritis was observed in all cases (63 % with activity, 31 % with intestinal metaplasia, and 61 % with foveolar hyperplasia). Erosion and ulceration of the overlying gastric mucosa was observed in 48 % and 11 % of the polyps, respectively. Onion skin features were present in 52 % of the polyps and were more frequently observed in cases without evidence of Helicobacter pylori infection. Background changes in gastric mucosa were not distinctive according to Helicobacter pylori infection. Chronic atrophic gastritis with intestinal metaplasia was associated with the presence of perivascular onion skin lesions. To our knowledge, this is the second largest series of gastric inflammatory fibroid polyps. Helicobacter pylori infection was identified in about half of the cases and was associated with a lower frequency of onion skin features in the polyps.
Insights
Inflammatory fibroid polyps, rare stomach growths, were studied for Helicobacter pylori infection. About half of these polyps showed H. pylori, which was linked to fewer "onion skin" features.
Area of Science:
- Gastroenterology
- Pathology
- Oncology
Background:
- Inflammatory fibroid polyps (IFPs) are uncommon mesenchymal lesions of the gastrointestinal tract.
- The association between Helicobacter pylori (H. pylori) infection and the clinicopathological characteristics of IFPs remains unclear.
Purpose of the Study:
- To evaluate the clinico-pathological features of gastric IFPs.
- To determine the frequency of H. pylori infection in the gastric mucosa overlying IFPs.
- To investigate the impact of H. pylori infection on the histological phenotype of IFPs.
Main Methods:
- Retrospective review of 54 gastric IFPs diagnosed between 1998 and 2012.
- Histological examination using hematoxylin and eosin, modified Giemsa stain for H. pylori, and immunohistochemistry.
- Analysis of associated background gastric mucosa changes, including gastritis activity, intestinal metaplasia, and foveolar hyperplasia.
Main Results:
- IFPs predominantly affected females (85%), with a mean age of 63 years.
- H. pylori infection was detected in 48% of cases.
- "Onion skin" features were observed in 52% of polyps and were less frequent in H. pylori-positive cases. Chronic atrophic gastritis with intestinal metaplasia correlated with perivascular onion skin lesions.
Conclusions:
- This study represents one of the largest series of gastric IFPs.
- H. pylori infection is present in about half of gastric IFPs and is associated with a reduced prevalence of "onion skin" features.
- The findings contribute to understanding the relationship between H. pylori and the histopathological presentation of IFPs.
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