{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T18:10:38Z","timestamp":1789582238715,"version":"build-2803163510"},"reference-count":50,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,2,16]],"date-time":"2017-02-16T00:00:00Z","timestamp":1487203200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Massive gastric polyposis is a rare entity that is often associated with juvenile polyposis syndrome (<jats:styled-content style=\"fixed-case\">JPS<\/jats:styled-content>). The aim of this study was to evaluate the clinicopathological features of 22 patients with abundant gastric juvenile\u2010type or hyperplastic\u2010like polyps.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>The study included 12 males and 10 females with a median age of 48 years (range: 13\u201379 years). Fourteen (64%) patients carried a diagnosis of <jats:styled-content style=\"fixed-case\">JPS<\/jats:styled-content>, and three had prior gastrointestinal adenocarcinomas. Patients without known <jats:styled-content style=\"fixed-case\">JPS<\/jats:styled-content> presented at an older median age (60 years versus 40 years; <jats:italic>P<\/jats:italic> = 0.0068). Clinical symptoms included nausea, vomiting, and abdominal pain; 23% of patients were asymptomatic. Eighteen cases showed complete or near\u2010complete carpeting of the gastric mucosa by innumerable polyps, ranging from a few millimetres to ~100 mm. Most polyps formed long, bulbous projections and had characteristic histological features, including a smooth outer contour, prominent stromal oedema, and widely spaced, often cystically dilated glands lined by foveolar epithelium; some polyps had less stroma and more hyperplastic foveolar epithelium. All had normal underlying or adjacent mucosa. Four (18%) cases harboured adenocarcinoma, and seven (32%) others showed dysplasia. <jats:styled-content style=\"fixed-case\">SMAD<\/jats:styled-content>4 immunohistochemical staining showed patchy loss in polyps from 19 of 20 cases tested. Five of six (84%) patients tested had a germline <jats:italic><jats:styled-content style=\"fixed-case\">SMAD<\/jats:styled-content>4<\/jats:italic> mutation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Massive gastric juvenile\u2010type polyposis can occur in patients with and without known <jats:styled-content style=\"fixed-case\">JPS<\/jats:styled-content>, and may mimic different conditions, such as other polyposis syndromes and M\u00e9n\u00e9trier disease. Pathologists play an important role in disease classification, as some patients lack a family or personal history of <jats:styled-content style=\"fixed-case\">JPS<\/jats:styled-content>, have few if any colonic polyps, and may not harbour diagnostic germline mutations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.13149","type":"journal-article","created":{"date-parts":[[2016,12,19]],"date-time":"2016-12-19T13:27:25Z","timestamp":1482154045000},"page":"918-928","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Massive gastric juvenile\u2010type polyposis: a clinicopathological analysis of 22 cases"],"prefix":"10.1111","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5526-4220","authenticated-orcid":false,"given":"Raul S","family":"Gonzalez","sequence":"first","affiliation":[{"name":"Department of Pathology and Laboratory Medicine University of Rochester Medical Center Rochester NY 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