Stomal polypoid hypertrophic gastritis: a polypoid gastric lesion at gastroenterostomy site

Four cases of stomal polyps (the so-called gastritis cystica polyposa--GCP) at the gastroenterostomy site were studied with detailed description of their macroscopic and histologic features. Thirty-eight cases with reresection of the stomach including the site of previous gastroenterostomy were used for a comparative study. In 25 (66%) of the 38 cases localized mucosal hypertrophy of varying degrees was recognized near the site of anastomosis, the morphology corresponding well, though of the smaller scale, to that of the GCP both macroscopically and histologically. Macroscopic and histologic continuity was traced between the minimal protrusion of the stomal gastric mucosa and the stomal polyps. It is suggested that the GCP is an extreme occasion of stomal gastritis characterized by atrophy and pseudopyloric gland metaplasia of the fundic glands often with their submucosal invasion and hyperplasia of the surface and foveolar epithelia, these being probably caused by reflux of duodenal contents. It must be borne in mind that such lesions do exist at the site of gastrojejunostomy to be strictly differentiated from malignancies at the gastric stump.