In Search of Nodular Gastric Antral Vascular Ectasia A Distinct Entity or Simply Hyperplastic Polyps Arising in Gastric Antral Vascular Ectasia?

Monica Sanchez-Avila, Khalid Amin, Aastha Chauhan, Zhuo Geng, Shawn Mallery, Dale C. Snover

Research output: Contribution to journalArticlepeer-review

Abstract

Context.—Nodular gastric antral vascular ectasia (GAVE) is a reported phenotype of GAVE that has histologic features overlapping with gastric hyperplastic polyps (GHPs), with additional features often seen in flat mucosa of GAVE. Objective.—To determine if nodular GAVE and GHPs are distinct lesions by evaluating the prevalence of features reported in nodular GAVE in GHPs with or without associated GAVE. Design.—A review of all lesions diagnosed as GHPs between 2014 and 2017 was performed. Slides were analyzed for a number of features including established histologic features of GAVE without knowledge of clinical or endoscopic features. Results.—A total of 90 polyps were analyzed including 18 from patients with GAVE (20%). GAVE polyps were larger than non-GAVE polyps (average size, 1.3 cm versus 0.68 cm; P, .001), with more common extensive ulceration and associated granulation tissue (61.11% [n ¼ 11] versus 4.17% [n ¼ 3]; P ¼ .004), fibrin thrombi (50% [n ¼ 9] versus 15% [n ¼ 11]; P ¼ .003), moderate to marked vascular ectasia (83% [n ¼ 15] versus 35% [n ¼ 11]; P ¼ .001), and fibrohyalinosis (72% [n ¼ 13] versus 28% [n ¼ 20]; P ¼ .001). All polyps showed foveolar hyperplasia and smooth muscle proliferation. There were no features that were exclusively found in GAVE or non-GAVE cases. Conclusions.—Nodular GAVE appears to represent GHPs arising in a background of GAVE, with superimposed features found in flat mucosa of GAVE stomachs. The presence of fibrin thrombi, marked vascular ectasia, fibrohyalinosis, and/or ulceration in a GHP is suggestive but not diagnostic of GAVE, and the absence of these features does not rule out GAVE.

Original languageEnglish (US)
Pages (from-to)55-60
Number of pages6
JournalArchives of Pathology and Laboratory Medicine
Volume148
Issue number1
DOIs
StatePublished - Jan 2024

Bibliographical note

Publisher Copyright:
© 2024 College of American Pathologists. All rights reserved.

PubMed: MeSH publication types

  • Review
  • Journal Article

Fingerprint

Dive into the research topics of 'In Search of Nodular Gastric Antral Vascular Ectasia A Distinct Entity or Simply Hyperplastic Polyps Arising in Gastric Antral Vascular Ectasia?'. Together they form a unique fingerprint.

Cite this