Fundic Gland Polyps in the Pediatric Population: Clinical and Histopathologic Studies

Amy Coffey, Kalyani Patel, Norma Quintanilla, Richard Kellermayer, Hao Wu

Research output: Contribution to journalArticle

Abstract

We retrospectively studied the clinical and histologic features of pediatric fundic gland polyps (FGPs) in 16 patients. FGPs had an endoscopic prevalence of 0.25% in 8527 pediatric gastric biopsies. Five patients had familial adenomatous polyposis (FAP). The median age of onset was 17.7 years in FAP and 17.3 years in sporadic patients. All syndromic patients were asymptomatic and FGPs were identified during surveillance for existing or concurrent colon polyps. They did not take antacids. In comparison, all 11 sporadic FGPs were identified during evaluation of symptomatic patients who had taken antacids (median duration 21 months). Syndromic FGPs can be multiple at single endoscopy and were more likely to recur, while sporadic FGPs were often single. None of the sporadic patients had recurrence of FGPs or a subsequent diagnosis of FAP during a median follow-up of 20.5 months. The dilated fundic glands were lined by parietal and chief cells only in a majority (22/41, 53.7%) of syndromic FGPs, while additional tall mucinous lining cells were found in all sporadic FGPs. Syndromic FGPs did not have parietal cell hypertrophy in the background oxyntic mucosa. Nuclear immunopositivity for beta-catenin was essentially absent in all the FGPs. In conclusion, FGPs were rare in pediatric patients. In syndromic patients, FGPs are asymptomatic and did not precede colon polyps. Prolonged antacid intake seems to be associated with development of sporadic FGPs. Cellular components of dilated fundic glands and background parietal cell hypertrophy can be useful features to eliminate concern for syndromic polyposis.

Original languageEnglish (US)
Pages (from-to)482-489
Number of pages8
JournalPediatric and Developmental Pathology
Volume20
Issue number6
DOIs
StatePublished - Dec 1 2017

Fingerprint

Polyps
Pediatrics
Population
Antacids
Adenomatous Polyposis Coli
Clinical Studies
Hypertrophy
Colon
beta Catenin
Age of Onset
Endoscopy
Stomach

Keywords

  • familial adenomatous polyposis
  • fundic gland polyps
  • histopathology
  • nuclear beta-catenin
  • pediatric

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pathology and Forensic Medicine

Cite this

Fundic Gland Polyps in the Pediatric Population : Clinical and Histopathologic Studies. / Coffey, Amy; Patel, Kalyani; Quintanilla, Norma; Kellermayer, Richard; Wu, Hao.

In: Pediatric and Developmental Pathology, Vol. 20, No. 6, 01.12.2017, p. 482-489.

Research output: Contribution to journalArticle

Coffey, Amy ; Patel, Kalyani ; Quintanilla, Norma ; Kellermayer, Richard ; Wu, Hao. / Fundic Gland Polyps in the Pediatric Population : Clinical and Histopathologic Studies. In: Pediatric and Developmental Pathology. 2017 ; Vol. 20, No. 6. pp. 482-489.
@article{fd99a17a87024e5784c01dac4a52ac37,
title = "Fundic Gland Polyps in the Pediatric Population: Clinical and Histopathologic Studies",
abstract = "We retrospectively studied the clinical and histologic features of pediatric fundic gland polyps (FGPs) in 16 patients. FGPs had an endoscopic prevalence of 0.25{\%} in 8527 pediatric gastric biopsies. Five patients had familial adenomatous polyposis (FAP). The median age of onset was 17.7 years in FAP and 17.3 years in sporadic patients. All syndromic patients were asymptomatic and FGPs were identified during surveillance for existing or concurrent colon polyps. They did not take antacids. In comparison, all 11 sporadic FGPs were identified during evaluation of symptomatic patients who had taken antacids (median duration 21 months). Syndromic FGPs can be multiple at single endoscopy and were more likely to recur, while sporadic FGPs were often single. None of the sporadic patients had recurrence of FGPs or a subsequent diagnosis of FAP during a median follow-up of 20.5 months. The dilated fundic glands were lined by parietal and chief cells only in a majority (22/41, 53.7{\%}) of syndromic FGPs, while additional tall mucinous lining cells were found in all sporadic FGPs. Syndromic FGPs did not have parietal cell hypertrophy in the background oxyntic mucosa. Nuclear immunopositivity for beta-catenin was essentially absent in all the FGPs. In conclusion, FGPs were rare in pediatric patients. In syndromic patients, FGPs are asymptomatic and did not precede colon polyps. Prolonged antacid intake seems to be associated with development of sporadic FGPs. Cellular components of dilated fundic glands and background parietal cell hypertrophy can be useful features to eliminate concern for syndromic polyposis.",
keywords = "familial adenomatous polyposis, fundic gland polyps, histopathology, nuclear beta-catenin, pediatric",
author = "Amy Coffey and Kalyani Patel and Norma Quintanilla and Richard Kellermayer and Hao Wu",
year = "2017",
month = "12",
day = "1",
doi = "10.1177/1093526617706816",
language = "English (US)",
volume = "20",
pages = "482--489",
journal = "Pediatric and Developmental Pathology",
issn = "1093-5266",
publisher = "Society for Pediatric Pathology",
number = "6",

}

TY - JOUR

T1 - Fundic Gland Polyps in the Pediatric Population

T2 - Clinical and Histopathologic Studies

AU - Coffey, Amy

AU - Patel, Kalyani

AU - Quintanilla, Norma

AU - Kellermayer, Richard

AU - Wu, Hao

PY - 2017/12/1

Y1 - 2017/12/1

N2 - We retrospectively studied the clinical and histologic features of pediatric fundic gland polyps (FGPs) in 16 patients. FGPs had an endoscopic prevalence of 0.25% in 8527 pediatric gastric biopsies. Five patients had familial adenomatous polyposis (FAP). The median age of onset was 17.7 years in FAP and 17.3 years in sporadic patients. All syndromic patients were asymptomatic and FGPs were identified during surveillance for existing or concurrent colon polyps. They did not take antacids. In comparison, all 11 sporadic FGPs were identified during evaluation of symptomatic patients who had taken antacids (median duration 21 months). Syndromic FGPs can be multiple at single endoscopy and were more likely to recur, while sporadic FGPs were often single. None of the sporadic patients had recurrence of FGPs or a subsequent diagnosis of FAP during a median follow-up of 20.5 months. The dilated fundic glands were lined by parietal and chief cells only in a majority (22/41, 53.7%) of syndromic FGPs, while additional tall mucinous lining cells were found in all sporadic FGPs. Syndromic FGPs did not have parietal cell hypertrophy in the background oxyntic mucosa. Nuclear immunopositivity for beta-catenin was essentially absent in all the FGPs. In conclusion, FGPs were rare in pediatric patients. In syndromic patients, FGPs are asymptomatic and did not precede colon polyps. Prolonged antacid intake seems to be associated with development of sporadic FGPs. Cellular components of dilated fundic glands and background parietal cell hypertrophy can be useful features to eliminate concern for syndromic polyposis.

AB - We retrospectively studied the clinical and histologic features of pediatric fundic gland polyps (FGPs) in 16 patients. FGPs had an endoscopic prevalence of 0.25% in 8527 pediatric gastric biopsies. Five patients had familial adenomatous polyposis (FAP). The median age of onset was 17.7 years in FAP and 17.3 years in sporadic patients. All syndromic patients were asymptomatic and FGPs were identified during surveillance for existing or concurrent colon polyps. They did not take antacids. In comparison, all 11 sporadic FGPs were identified during evaluation of symptomatic patients who had taken antacids (median duration 21 months). Syndromic FGPs can be multiple at single endoscopy and were more likely to recur, while sporadic FGPs were often single. None of the sporadic patients had recurrence of FGPs or a subsequent diagnosis of FAP during a median follow-up of 20.5 months. The dilated fundic glands were lined by parietal and chief cells only in a majority (22/41, 53.7%) of syndromic FGPs, while additional tall mucinous lining cells were found in all sporadic FGPs. Syndromic FGPs did not have parietal cell hypertrophy in the background oxyntic mucosa. Nuclear immunopositivity for beta-catenin was essentially absent in all the FGPs. In conclusion, FGPs were rare in pediatric patients. In syndromic patients, FGPs are asymptomatic and did not precede colon polyps. Prolonged antacid intake seems to be associated with development of sporadic FGPs. Cellular components of dilated fundic glands and background parietal cell hypertrophy can be useful features to eliminate concern for syndromic polyposis.

KW - familial adenomatous polyposis

KW - fundic gland polyps

KW - histopathology

KW - nuclear beta-catenin

KW - pediatric

UR - http://www.scopus.com/inward/record.url?scp=85040829317&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85040829317&partnerID=8YFLogxK

U2 - 10.1177/1093526617706816

DO - 10.1177/1093526617706816

M3 - Article

C2 - 28429649

AN - SCOPUS:85040829317

VL - 20

SP - 482

EP - 489

JO - Pediatric and Developmental Pathology

JF - Pediatric and Developmental Pathology

SN - 1093-5266

IS - 6

ER -