Benign epithelial polyps of the stomach.

It is clear that benign gastric epithelial polyps form a heterogeneous group with distinct pathologic features. Variability exists in regard to malignant potential and association with various polyposis syndromes. The most important aspects of these lesions are as follows: The only gastric polyps with a direct malignant potential are the neoplastic polyps. Since these lesions are most commonly solitary and antral, and such lesion identified at endoscopy or radiographically should be removed. The hyperplastic polyps, the most common of gastric polyps, are frequently associated with carcinoma, but probably do not have any malignant potential over and above that of the atrophic gastritis which usually accompanies them. Fundic-gland hyperplasia, a poorly recognized but common entity, carries no malignant potential. The diagnosis of FGH should be suspected in cases where the fundus and body of the stomach are carpeted with sessile 1 to 5 mm polyps. Since these lesions may spontaneously regress, no therapy is needed other than biopsy to confirm the diagnosis. However, because of the association with familial polyposis and Gardner's syndrome, patients with FGH should be evaluated for the possibility of one of these syndromes. Since in some cases several types of polyps may occur in the same stomach, it may be necessary to biopsy several in order to be sure a neoplastic polyp is not present. In cases of multiple gastric polyposis in which variability of gross appearance is noted, polyps of several types should be biopsied. Since the neoplastic polyps tend to be larger, pedunculated, and antral in location, lesions with these characteristics should be removed.