the Old Quiz
The Old Endoscopy Quiz (and Answer) of the Month February 2006

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Question:
And so the days are getting lighter as the sun is rising here in the North of Europe. This gentleman in his middle age came to an upper endoscopy because of reflux symptoms, and was found to have an hiatal hernia och a slight scarring in the distal oesophagus. The images above shows the finding in his gastric body. Quite a lot of biopsies were taken - what will they show?
Answer:
Gastric hyperplastic polyps.
Small hyperplastic polyps in the gastric body are common and they do not have much clinical significance, however we should try to take biopsies from most of them. Should a finding like this be followed up?
Probably no, but said that, there are other opinions, like in this abstract:

Correct answers and comments were emailed by
Yogi Reddy, Manchester, UK
Dr.Virendra Parikh, Fort Wayne, USA, Indiana
Moutaz Derbala, Cairo, Egypt
German Lloret Salom, Alzira, Spain
Peter Ferko, Velke Kapusany, Slovakia
Noa Ciuraru, Zoran, Israel
 Night in Orlando, Florida
Marion Ricket, Orlando, Fla. USA
Salvatore Della Ducata, Gallipoli, Italy
Ervin Toth, Malmö, Sweden
Op.Dr.Pakize DEMİRKALEM, İSTANBUL, TURKEY
Cecilia Monsalve Jacome, Caracas, Venezuela
Ellie Pongratz, Bowie, MD
Louis Aviles MD, Clearwater, USA/ Florida
radu ionescu, Bucharest, Romania
Zahreddine Radwan, Beirut, Lebanon
PARABOLI SILVA, Marcio Luiz, SAO JOSE DO RIO PRETO, BRAZIL
LUISGUILLERMOGUERRERO, BOGOTA, COLOMBIA
CLAUDIAZITRON, SAO PAULO, BRASIL
n satish, pondicherry, India
Claudia Iacobescu, Bucharest, Romania
aissaoui lotfi, kef, tunisia
Dr.Arber Veliu, Prishtina, Kosovo
dr teoman parmaksızoğlu, Izmit, turkey
Klaudia J.Niepsuj, Gliwice, Poland
lorna kirkham, milton keynes, UK
Abdon Guerra, San Antonio, Chile
U. Cuartas, Augusta, USA
Subbaramiah Sridhar, Augusta, Georgia, USA
bilardi claudio, sanremo, Italy
Hiam Mustafa, Khartoum, Sudan
Comments:
Benign polyps due to long term PPICystically dilated glands lined by gastric body type mucosa on histologyIrregular shortened foveolae, smooth muscle fibres around the dilated glands.Hypertrophy and hyperplasiaof parietal cells in patients treated with proton pump inhibitors.
gastric polyps need diferentiation with innflamatory, adenomatous and the biopsy will do it, if is bigeer than 2 cm adenoma is possble and for the size needs to r/o carcinoma.
Traditionally called fundic gland polyps, could be seen in the body as well caused by prolonged use of PPI therapy.

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