Journal
CLINICAL JOURNAL OF GASTROENTEROLOGY
Volume 14, Issue 1, Pages 98-102Publisher
SPRINGER JAPAN KK
DOI: 10.1007/s12328-020-01294-2
Keywords
Autoimmune gastritis; Pseudopolyp; Fundic gland polyp; Enterochromaffin-like cell hyperplasia
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Pseudopolyps in autoimmune gastritis (AIG) are a type of remnant oxyntic mucosa with characteristic endoscopic findings. This case report describes a rare occurrence of fundic gland polyp (FGP)-like pseudopolyps with nodular ECL cell hyperplasia in AIG, demonstrating distinctive features in both endoscopic and histopathological examinations.
Pseudopolyps, a type of remnant oxyntic mucosa on a background of corpus-restricted mucosal atrophy, are a characteristic endoscopic finding in autoimmune gastritis (AIG). Linear or nodular enterochromaffin-like (ECL) cell hyperplasia, a characteristic histopathological finding of AIG, is not generally found in pseudopolyps. We report a case of AIG with fundic gland polyp (FGP)-like pseudopolyps containing nodular ECL cell hyperplasia. A 64-year-old man underwent esophagogastroduodenoscopy, which revealed atrophic changes limited to the corpus, with a normal antrum. The greater curvature was less atrophic than the lesser curvature. Sessile or semipedunculated polypoid lesions were observed on the greater curvature and on the anterior and posterior walls of the corpus. The polypoid lesions resembled FGPs, although some were larger than FGPs generally are. Histologically, non-atrophic fundic glands with parietal cell pseudohypertrophy were observed in the upper regions of the polypoid lesions. By contrast, at the base of the lesions, where linear and nodular ECL cell hyperplasia was identified by immunohistochemical staining, destruction of fundic glands with lymphocytic infiltration, loss of parietal cells, and pseudopyloric metaplasia was observed. Anti-parietal cell antibody positivity and hypergastrinemia confirmed the diagnosis of AIG with pseudopolyps. FGP-like pseudopolyps can, therefore, be present with nodular ECL cell hyperplasia in AIG.
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