Clinical history: Gastric polyps in an 80 year old female.
What is the most proable diagnosis?
Fundic type gastric mucosa with fundic gland polyp and gastric xanthoma
Fundic gland polyps (picture 2) are usually single or multiple small (2 mm) polypoid projections in gastric fundus and considered to be hamartomas or peculiar form of hyperplastic polyp. When multiple, they can be associated with protein pump inhibitors treatment.
Microscopically, they are characterized by dilated glands and microcysts lined by fundic epithelium, shortened foveola, increased smooth muscle in lamina propria, and no proliferation of foveolar epithelium.
Gastric xanthoma (picture 3) has no clinical significance and may be due to bile reflux. Grossly, they represent as single or multiple small yellow / cream colored intramucosal lesion measuring less than 5 mm. Microscopically, they are characterized by foamy histiocytes with neutral fat in the lamina propria.