Gastric Adenomas and Mimickers: A Review.

Area of Science:

• Gastroenterology
• Pathology
• Oncology

Background:

• Gastric adenomas are premalignant epithelial neoplasms with varied endoscopic appearance.
• Accurate histological classification is crucial, as subtypes differ in malignant potential and associated conditions.
• Distinguishing between the four World Health Organization (WHO) classified subtypes (intestinal, foveolar-type, oxyntic gland, pyloric gland adenoma) can be challenging due to overlapping features.

Purpose of the Study:

• To provide a practical guide for the histopathologic diagnosis of gastric adenomas.
• To summarize evidence on the risk of malignancy and malignant transformation associated with gastric adenomas.
• To review current clinical follow-up and management recommendations for gastric adenomas.

Main Methods:

• Literature review focusing on histopathologic features of gastric adenoma subtypes.
• Synthesis of evidence regarding malignant potential and associated conditions.
• Review of clinical guidelines for management and follow-up.
• Inclusion of a review of epithelial and non-epithelial mimickers of gastric adenomas.

Main Results:

• Gastric adenomas are classified into four distinct WHO subtypes with unique histologic features.
• Each subtype carries a different risk of malignant transformation.
• Mimickers of gastric adenomas, both epithelial and non-epithelial, can complicate diagnosis.
• Management strategies vary based on adenoma subtype and associated risks.

Conclusions:

• Accurate histopathologic diagnosis of gastric adenoma subtypes is essential for risk stratification and management.
• Understanding the malignant potential and recognizing mimickers are critical for optimal patient care.
• Standardized diagnostic criteria and clear management guidelines are necessary for these premalignant lesions.