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Updated: Mar 28, 2026
Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
Complete Resolution of Pseudomalignant Erosion in a Reflux Gastroesophageal Polyp with Proton Pump Inhibitor
Takahiko Nakajima1, Haruo Yagi2, Hayato Baba1
1Department of Diagnostic Pathology, Graduate School of Medicine and Pharmaceutical Science, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan.
Abstract:
Pseudomalignant erosion is a diagnostic pitfall for pathologists in the differential diagnosis of malignant neoplasms. Here, we present a challenging case of a biopsy specimen from the eroded head of a polyp at the esophagogastric junction. A malignant neoplasm could not be ruled out due to the presence of bizarre stromal cells. A second biopsy performed after the administration of a proton pump inhibitor (PPI) for 4 weeks revealed endoscopic resolution of the polyp along with the complete histological resolution of the bizarre stromal cells and led to the diagnosis of pseudomalignant erosion in a reflux gastroesophageal polyp. In conclusion, histological and endoscopic response to PPI therapy is an important clue for the correct diagnosis of reflux gastroesophageal polyps with pseudomalignant erosion.
Insights
Pseudomalignant erosion in reflux polyps can mimic cancer. Prompt diagnosis and treatment with proton pump inhibitors (PPIs) led to resolution, confirming this benign condition.
Area of Science:
- Gastroenterology
- Pathology
- Oncology
Background:
- Pseudomalignant erosion is a diagnostic challenge, often mistaken for malignant neoplasms.
- Bizarre stromal cells in biopsy specimens can obscure accurate diagnosis.
Purpose of the Study:
- To present a case of pseudomalignant erosion in a reflux gastroesophageal polyp.
- To highlight the diagnostic utility of proton pump inhibitor (PPI) therapy.
Main Methods:
- A challenging biopsy case from an esophagogastric junction polyp was analyzed.
- A second biopsy was performed after 4 weeks of PPI treatment.
Main Results:
- Initial biopsy showed bizarre stromal cells, raising concern for malignancy.
- Post-PPI therapy, endoscopic and histological resolution of abnormalities occurred.
- Diagnosis of pseudomalignant erosion in a reflux gastroesophageal polyp was confirmed.
Conclusions:
- Histological and endoscopic response to PPI therapy is crucial for diagnosing pseudomalignant erosion.
- This highlights the importance of considering PPI response in reflux gastroesophageal polyps.
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