Hyperplastic polyp

Author: Elliot Weisenberg, M.D. (see Authors page)

Revised: 5 December 2016, last major update August 2012

Copyright: (c) 2003-2016,, Inc.

PubMed Search: stomach hyperplastic polyp
Cite this page: Hyperplastic polyp. website. Accessed June 24th, 2017.
Definition / general
  • Also called inflammatory, regenerative polyps
  • Different from colonic hyperplastic polyps but similar to colonic inflammatory pseudopolyps
  • Nonneoplastic, represents about 75% of all gastric polyps
  • Associated with background mucosal disease in 85% of cases, particularly chronic gastritis with glandular atrophy and intestinal metaplasia; H. pylori gastritis, chemical (reactive) gastropathy, thus, endoscopists should also biopsy surrounding mucosa to evaluate underlying gastric abnormalities
  • Also associated with hypochlorhydria and hypergastrinemia
  • Multiple polyps associated with autoimmune gastritis
  • Usually age 50+
  • Rare / no malignant potential by itself, although present in 20% of stomachs resected for carcinoma (chronically inflamed and atrophic mucosa tends to form hyperplastic polyps and to degenerate into malignancy)
  • Hyperplastic polyps with even low grade dysplasia may have significant risk for associated carcinoma (Hum Pathol 2002;33:1016)
Gross description
  • Small (mean 1.4 cm, range 0.5 to 2 cm), sessile, multiple (20%), 60% in antrum
  • Smooth or slightly lobulated
  • Central umbilication common, more proximal when associated with autoimmune gastritis
Microscopic (histologic) description
  • Elongated, tortuous or dilated gastric foveola with pyloric or fundic glands (Am J Surg Pathol 2001;25:500)
  • Lamina propria has inflammatory cells, scattered smooth muscle bundles, edema, patchy necrosis
  • Associated with chronic, active (H. pylori), reactive gastritis and atrophic autoimmune gastritis
  • Rarely foamy macrophages
  • Surface mucosa may be regenerative, but dysplasia in only 4%
  • Focal intestinal metaplasia in 16%
  • May regress when H. pylori gastritis is treated
Microscopic (histologic) images

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Hyperplastic polyps