Sporadic foveolar-type gastric adenoma with a raspberry-like appearance in Helicobacter pylori–naïve patients

Shibagaki, Kotaro; Mishiro, Tsuyoshi; Fukuyama, Chika; Takahashi, Yusuke; Itawaki, Ayako; Nonomura, Saya; Yamashita, Noritsugu; Kotani, Shunsuke; Mikami, Haruo; Izumi, Daisuke; Kawashima, Kousaku; Ishimura, Norihisa; Nagase, Mamiko; Araki, Asuka; Ishikawa, Noriyoshi; Maruyama, Riruke; Kushima, Ryoji; Ishihara, Shunji

doi:10.1007/s00428-021-03124-3

Cited by 18 publications

(18 citation statements)

References 32 publications

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“…Most of the gastric foveolar-type adenomas are related to hereditary tumor syndromes, such as familial adenomatous polyposis (FAP) and gastric adenocarcinoma and proximal gastric polyposis (GAPPS), and only a few sporadic cases have been reported [ 4 , 5 ]. FAP is a series of syndromes including gastrointestinal polyps, cancer, and extracolonic lesion caused by germline mutations of the APC gene [ 3 , 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…We reported here a protruding lesion with a maximum diameter of 2.3 cm, which caused symptoms of gastrointestinal bleeding. Recently, there is a study about a type of sporadic gastric foveolar-type adenoma with a raspberry-like appearance [ 5 ], which is considered as a special subtype of sporadic foveolar-type adenoma. The cases they reported were all located in the upper or middle stomach, and the mean lesion size was quite small at 3.2 ± 2.6 mm.…”

Section: Discussionmentioning

confidence: 99%

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Sporadic foveolar-type adenoma in gastric body/antrum junction with gastritis cystica profunda

Guan

Shen

et al. 2022

BMC Gastroenterol

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Background Sporadic gastric foveolar-type adenomas are extremely rare and are usually small, flat or slightly raised lesions that occur in the oxyntic mucosa. Case presentation We reported here a case of a 70-year-old female with a sporadic gastric foveolar-type adenoma occurring in the mucosa at the junction of the gastric body/antrum. The adenoma was a protruding lesion of 2 × 1.8 cm sized, causing symptoms of upper gastrointestinal bleeding, and the basal and surrounding mucosa showed pseudopyloric gland metaplasia without atrophy, intestinal metaplasia, H. pylori infection, or active inflammation. It had somatic mutations in both APC and KRAS genes. Conclusions This is the first reported case of a large sporadic gastric foveolar-type adenoma that occurred in the mucosa of pseudopyloric gland metaplasia and with Gastritis Cystica Profunda, which modify our understanding of the morphological features and molecular underpinnings of this type of lesion.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Sporadic foveolar-type adenoma in gastric body/antrum junction with gastritis cystica profunda

Guan

Shen

et al. 2022

BMC Gastroenterol

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“…1C, D). 6,7 Hereafter, we refer to the respective subtypes of lesions as flat FA and raspberry-like FA. Sporadic, flat FAs were significantly larger than raspberry-like FAs (P = 0.0040).…”

Section: Clinicopathological Featuresmentioning

confidence: 99%

“…These were small, averaging 3 mm in size, and appeared as bright-red protrusions with a finely granular surface, reminiscent of raspberries 6,7. Notably, although sporadic FA had been described as an extremely rare type of lesion, FAs with a raspberry-like appearance constituted 34 of 50 gastric neoplasms identified in H. pylori –naive patients in a recent study 7. This suggested that they are rather common but may have been overlooked.…”

mentioning

confidence: 99%

“…Recently, a clinicopathologically distinct variant of FA, endoscopically appearing raspberry-like, has been reported 6,7. These were small, averaging 3 mm in size, and appeared as bright-red protrusions with a finely granular surface, reminiscent of raspberries 6,7. Notably, although sporadic FA had been described as an extremely rare type of lesion, FAs with a raspberry-like appearance constituted 34 of 50 gastric neoplasms identified in H. pylori –naive patients in a recent study 7.…”

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confidence: 99%

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Sporadic and Familial Adenomatous Polyposis-associated Foveolar-type Adenoma of the Stomach

Naka¹,

Hashimoto²,

Cho

et al. 2022

American Journal of Surgical Pathology

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Gastric foveolar-type adenoma (FA) is a rare benign neoplasm occurring either sporadically or in patients with familial adenomatous polyposis (FAP). However, the molecular features of FA and the relationship between sporadic and syndromic lesions remain unclear. In this study, we performed clinicopathological, immunohistochemical, and genetic analyses of 18 sporadic and 30 FAP-associated FAs. Most sporadic and FAP-associated FAs were located in the upper or middle third of the stomach, on a background of fundic gland mucosa. Most lesions were low-grade, but 3 lesions had a high-grade component. Sporadic FAs included 2 morphologically distinct subtypes, that is, flat and raspberry-like FAs, which we distinguished based on the endoscopic features. Seven lesions were regarded as flat FAs, appearing as large, slightly elevated lesions and measuring 11 to 87 mm in size. Conversely, 10 raspberry-like FAs were small bright-red polyps, measuring 2 to 8 mm in size. FAPassociated FAs, particularly larger lesions, exhibited morphologic features resembling flat FAs but varied significantly in size (2 to 103 mm). Mutation analysis identified APC and KRAS mutations in all flat FAs but never in raspberry-like FAs. Remarkably, somatic APC and KRAS mutations were also detected in 19 (63%) and 27 (90%) of FAP-associated FAs, respectively. This indicates that they are genetically equivalent to sporadic, flat FAs. This study showed that sporadic FA includes at least 2 morphologically and genetically distinct subtypes: flat and raspberry-like FA. Furthermore, flat FA represents a sporadic counterpart of FAP-associated FA.

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The updated WHO classification of digestive system tumours—gastric adenocarcinoma and dysplasia

Kushima

2021

Pathologe

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Sporadic foveolar-type gastric adenoma with a raspberry-like appearance in Helicobacter pylori–naïve patients

Cited by 18 publications

References 32 publications

Sporadic foveolar-type adenoma in gastric body/antrum junction with gastritis cystica profunda

Sporadic foveolar-type adenoma in gastric body/antrum junction with gastritis cystica profunda

Sporadic and Familial Adenomatous Polyposis-associated Foveolar-type Adenoma of the Stomach

The updated WHO classification of digestive system tumours—gastric adenocarcinoma and dysplasia

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