PMC5548674_01
(A) Initial endoscopic image. Note the presence of a regular arrangement of collecting venules (RAC) and no atrophic changes in the gastric body. (B) Initial endoscopic image. Note the presence of RAC and no atrophic changes in the gastric angle. (C) Histology of a biopsy specimen from the gastric antrum showed no atrophic change, no metaplasia, and no infiltration of neutrophils. [Hematoxylin and Eosin (H&E) staining, original magnification, 100x]. (D) Histology of a biopsy specimen from the gastric body showed no atrophic change, no metaplasia, and no infiltration of neutrophils. (H&E staining, original magnification, 100x).
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The endoscopic findings showed no infection with H. pylori according to the Kyoto classification, i.e., regular arrangement of collecting venules (RAC) in the gastric angle and no atrophic changes (Fig. 1A and B). The histological assessment of biopsy tissues showed no atrophic change, no intestinal metaplasia and no infiltration of neutrophils (Fig. 1C and D).
(A) Endoscopic image after 1 year of treatment with omeprazole, a proton pump inhibitor. Note the presence of gastric hyperplastic polyps in the gastric body. (B) Histology of a biopsy specimen from a gastric hyperplastic polyp showed elongation and the branching of foveolae. (Hematoxylin and Eosin staining, original magnification, 100x).
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GHPs (Fig. 2B). GHPs increased in size (Fig. 3) with the continual administration of omeprazole, and the serum gastrin level (SGL) after fasting increased to 529 pg/mL.
Endoscopic image after 4 years of treatment with a proton pump inhibitor. Note the increase in the size of the gastric hyperplastic polyps.
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GHPs (Fig. 2B). GHPs increased in size (Fig. 3) with the continual administration of omeprazole, and the serum gastrin level (SGL) after fasting increased to 529 pg/mL.
Pathological findings of a gastric hyperplastic polyp obtained during endoscopic mucosal resection. (A) Histology of an endoscopic mucosal resection specimen from a large gastric hyperplastic polyp. [Hematoxylin and Eosin (H&E) staining; original magnification, x2]. (B) Histology of the foveolar mucosa showing elongation and branching of the foveolae. (H&E staining; original magnification, x100). (C) Immunohistochemical staining with OK-524 revealed the focal expression of gastrin receptor (GR) in the foveolar epithelium. (Original magnification, x400). (D) 1: Immunohistochemical staining with OK-524 revealed no expression of GR in the foveolar epithelium of the gastric antrum mucosa as a negative control. 2: Immunohistochemical staining with OK-524 of parietal cells as a positive control. 3: Immunohistochemical staining with Anti-Proton Pump (H, K-ATPase alpha subunit) mAb of parietal cells.
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A pathological examination of the GHP tissue showed elongation, branching, twisting, and dilation of foveolae (Fig. 4A and B), and immunohistochemical staining revealed the expression of gastrin receptor (GR) using the polyclonal antibody OK-524 (1:100, Immuno-Biological Laboratories Corporation, Japan) in the focal foveolar epithelium (Fig. 4C).
Endoscopic image 1 year after the cessation of proton pump inhibitor treatment. Note the near-complete disappearance of gastric hyperplastic polyps.
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Repeated EGD performed 1 year after omeprazole was discontinued showed that nearly all GHPs had markedly decreased in size (Fig. 5).