Endoscopically treated gastritis cystica polyposa JS Park, S-J Myung, H-Y Jung, et al.
VOLUME 54, NO. 1, 2001 GASTROINTESTINAL ENDOSCOPY 101
From the Departments of Internal Medicine, Diagnostic Pathology,
Radiology, and the University of Ulsan College of Medicine, Asan
Medical Center, Seoul, Korea.
Reprint requests: Seung-Jae Myung, MD, Internal Medicine, Asan
Medical Center, University of Ulsan College of Medicine, 388-1,
Pungnap-dong, Songpa-gu, Seoul, 138-736, Korea.
Copyright © 2001 by the American Society for Gastrointestinal
Endoscopy 0016-5107/2001/$35.00 + 0 37/4/114412
doi:10.1067/mge.2001.114412
Endoscopic treatment of gastritis cystica
polyposa found in an unoperated stomach
Ju Sang Park, MD, Seung-Jae Myung, MD, Hwoon-Yong
Jung, MD, Suk-Kyun Yang, MD, Weon-Seon Hong, MD,
Jin-Ho Kim, MD, Gyeong Hoon Kang, MD, Hyun Kwon
Ha, MD,Young II Min, MD
Gastritis cystica polyposa (GCP), characterized
by polypoid hyperplasia of the gastric mucosa, is an
uncommon lesion that develops in patients who
have undergone gastroenterostomy with or without
gastric resection.
1,2
Endoscopically and radiological-
ly GCP appears as a polypoid mass that is almost
always on the gastric side of the anastomosis. This
lesion is rarely found in an unoperated stomach.
1,3,4
Because it is difficult to differentiate GCP from can-
cer both radiologically and endoscopically, surgery is
required in most cases for diagnosis.
1,2
This is a case
of GCP with unusual morphologic features that
occurred in an unoperated stomach. The patient was
treated successfully by endoscopic polypectomy.
CASE REPORT
A 44-year-old woman had complained of intermittent
epigastric pain for 3 years. One month before admission
EGD performed at another hospital identified a large
polypoid mass in the fundus of the stomach. There was no
history of gastrectomy or gastroenterostomy. Laboratory
studies including liver and renal function tests were with-
in the normal range.
EGD at our hospital revealed a pedunculated polyp
approximately 4 cm in diameter and erythematous
mucosa with a lobulated contour along the anterior wall
of the fundus. The surface of the polyp appeared slightly
bluish and transparent (Fig. 1A), suggesting a cystic
structure. The polyp was movable but there was no evi-
dence of bleeding. EUS demonstrated a homogeneous,
hypoechoic, and multilocular cystic mass with a stalk
(Fig. 1B); no solid component was seen. Biopsy speci-
mens from the surface of the polyp revealed only moder-
ate chronic gastritis with mild atrophy and intestinal
metaplasia.
Contrast-enhanced abdominal CT disclosed an intralu-
minal polypoid mass with a thick peripheral wall and
multiple cystic components along the greater curvature of