Duodenal gastric heterotopia: further evidence of an association with fundic gland polyps

Summary Duodenal gastric heterotopia (DGH) is a common incidental finding at endoscopy, generally assumed to be congenital in origin. A recent study has suggested a possible association with gastric fundal gland polyps (FGPs). In this review of 37 patients with histologically confirmed DGH, the back...

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Bibliographic Details
Published in:Human pathology 2013-04, Vol.44 (4), p.636-642
Main Authors: Conlon, Niamh, MB, FRCPath, Logan, Elaine, MSc, Veerappan, Sundaram, MB, MRCPI, McKiernan, Susan, MB, MRCP, O'Briain, Sean, FRCPath
Format: Article
Language:English
Subjects:
Acids
Adult
Aged
Aged, 80 and over
Choristoma - complications
Choristoma - microbiology
Choristoma - pathology
Duodenal Diseases - complications
Duodenal Diseases - microbiology
Duodenal Diseases - pathology
Duodenal gastric heterotopia
Family medical history
Female
Fundic gland polyps
Gastric Fundus - metabolism
Gastric Fundus - pathology
Gastric Mucosa - metabolism
Gastric Mucosa - pathology
Gastrointestinal diseases
H(+)-K(+)-Exchanging ATPase - metabolism
Helicobacter Infections - complications
Helicobacter Infections - pathology
Helicobacter pylori - isolation & purification
Humans
Hypergastrinemia
Immunohistochemistry
Male
Middle Aged
Mucins - metabolism
Pathology
Patients
Polyps - complications
Polyps - microbiology
Polyps - pathology
Rodents
Stomach
Stomach Diseases - complications
Stomach Diseases - microbiology
Stomach Diseases - pathology
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Summary:Summary Duodenal gastric heterotopia (DGH) is a common incidental finding at endoscopy, generally assumed to be congenital in origin. A recent study has suggested a possible association with gastric fundal gland polyps (FGPs). In this review of 37 patients with histologically confirmed DGH, the background to our present understanding of the DGH lesion is reviewed, the clinical and pathological associations of the condition in our cohort are identified, and the histological and immunohistochemical features of the DGH lesion are described. An association with the presence of FGPs is again demonstrated, whereas an inverse relationship with Helicobacter pylori is also shown. Immunohistochemical staining demonstrates that the fundic-type glands of DGH express the proton pump antigen (H+ K+ ATPase), whereas the overlying surface mucosa expresses the mucin profile of normal gastric-type mucosa (mucin-5AC positive, mucin-2 negative). DGH may represent a further component of the iatrogenic hypergastrinemia-related hypothesis for FGP development, although further study is required to confirm this.
ISSN:0046-8177
1532-8392
DOI:10.1016/j.humpath.2012.07.014