Gastric Hyperplastic Polyps: A Review

Hyperplastic polyps represent the commonest polyp encountered in the stomach. They occur in patients of either gender and are commoner in the seventh decade of life. They are usually asymptomatic, small (less than 1 cm in diameter), solitary lesions occurring in the antrum but can present with dyspepsia, heartburn, abdominal pain, or upper gastrointestinal (GI) bleeding leading to anemia. Hyperplastic polyps almost never occur in normal gastric mucosa and are most commonly associated with chronic gastritis (Helicobacter pylori or autoimmune-induced). Pathologically, they are characterized by dilated, tortuous gastric foveoli set within an inflamed, edematous stroma. There is considerable histologic overlap especially with Ménétrier’s disease and hamartomatous (juvenile or retention) polyps, and clinical input is mandatory to accomplish separation of these entities. Hyperplastic polyps arise as a by-product of repair to damaged mucosa. Dysplasia and malignancy are rarely associated with these polyps, which show an array of molecular aberrations. The importance of hyperplastic polyps for both gastroenterologist and pathologist lies in their association with other gastric mucosal pathology and mandates biopsy of adjacent mucosa and diligent search for accompanying pathology by the pathologist.