BACKGROUND Inflammatory fibroid polyps(IFPs)are generally considered as benign and relatively rare mesenchymal gastrointestinal tract tumors.IFPs can occur in any part of the gastrointestinal tract but are most preval...BACKGROUND Inflammatory fibroid polyps(IFPs)are generally considered as benign and relatively rare mesenchymal gastrointestinal tract tumors.IFPs can occur in any part of the gastrointestinal tract but are most prevalent in the stomach,particularly in the gastric antrum.With a low incidence in clinical practice and a lack of distinct endoscopic features,the preoperative diagnosis rate of IFP is disappointingly low,often leading to missed diagnoses or misdiagnoses.CASE SUMMARY A 43-year-old man,hospitalized with abdominal pain and distension,underwent his first gastroscopy in 2020,which revealed chronic superficial erosive gastritis.From 2021 to 2022,his condition progressed from antral ulcers to a 2.0 cm gastric antrum bulge of an unclear nature.After proton pump inhibitor treatment,the lesion shrank but did not heal completely.Following a thorough assessment using magnifying endoscopy with narrow-band imaging,gastric-enhanced computed tomography,and endoscopic ultrasonography,endoscopic submucosal dissection was performed on the identified lesion.A subsequent postoperative pathological examination conclusively diagnosed the lesion as an IFP.At 6 months follow-up,no recurrence or metastasis was observed,with good mucosal scar healing.CONCLUSION Through using multiple diagnostic and therapeutic test results,an IFP with an unusual morphology could be identified.展开更多
BACKGROUND The diagnosis of gastric inflammatory fibroid polyps(IFPs)mainly depends on pathological confirmation after endoscopic or surgical treatment.Gastric IFP have typical manifestations under endoscopic ultrason...BACKGROUND The diagnosis of gastric inflammatory fibroid polyps(IFPs)mainly depends on pathological confirmation after endoscopic or surgical treatment.Gastric IFP have typical manifestations under endoscopic ultrasonography(EUS),but atypical EUS features have also been reported.Previous studies have found that atypical features of gastric IFPs observed under EUS have corresponding histological manifestations.At present,there is no study elaborating the EUS manifestations of gastric IFPs at different pathological stages.We hypothesize that gastric IFPs at different pathological stages may have different EUS features.AIM To describe EUS features of gastric IFPs and compare with their pathological characteristics.METHODS Clinical data of 53 inpatients with pathologically diagnosed gastric IFPs after endoscopic treatment were collected.All patients underwent preoperative EUS.We analyzed the EUS characteristics of the lesions and compared with the pathological characteristics and staging of the resected specimens.RESULTS Most gastric IFPs showed medium-low echo(67.9%),homogeneous echo(90.6%),and unclear boundaries(83%),and involved the second and third layers of the gastric wall(69.8%)under EUS.The echogenicity level and echo homogeneity were significantly correlated with the pathological stage of gastric IFP.Gastric IFPs in the nodular stage presented hypoechoic and homogeneous echo.Gastric IFPs in the fibrovascular stage mostly showed medium-low echo and homogeneous echo.Gastric IFPs in the sclerotic stage showed different echogenicity levels and echo homogeneity.The accuracy of EUS in diagnosing gastric IFPs was 66.0%(35/53),and the accuracy in determining the origin layer of gastric IFPs was 73.4%(39/53).CONCLUSION Gastric IFPs at different pathological stages have different EUS features.In order to improve the diagnostic rate,it is necessary to combine EUS with EUS-guided fine-needle aspiration or artificial intelligence.展开更多
Objective: To review the diagnosis and differential diagnosis of inflammatory fibroid polyp (IFP) of gastrointestinal tract. Methods: The clinical symptoms, histopathologic features and immunohistochemical (ABC method...Objective: To review the diagnosis and differential diagnosis of inflammatory fibroid polyp (IFP) of gastrointestinal tract. Methods: The clinical symptoms, histopathologic features and immunohistochemical (ABC method) staining in 9 cases were observed. Results: IFP presented either as a solitary pedunculated or sessile lesion arising from the submucosa and protroding into the lumen; composed of a background of fibroblasts and blood vessels infiltrated by a variable number of inflammatory cells, often numerous eosinophilias leukocytes. Immunohistochemical staining: the spindle cells of all cases reacted with Vimentin. The partial cells of several cases react with Actin, NSE, a -AT. 7 cases were follow-up. No patients had a recurrence of the lesion. Conclusion: IFP are rare lesions, and may represent an exaggerated response to inflammatory or other injury process. The prognosis is good when treated by segmental resections of endoscopic removals.展开更多
With the widespread use of upper gastrointestinal endoscopy,more and more gastric polyps(GPs)are being detected.Traditional management strategies often rely on histopathologic examination,which can be time-consuming a...With the widespread use of upper gastrointestinal endoscopy,more and more gastric polyps(GPs)are being detected.Traditional management strategies often rely on histopathologic examination,which can be time-consuming and may not guide immediate clinical decisions.This paper aims to introduce a novel classification system for GPs based on their potential risk of malignant transformation,categorizing them as"good","bad",and"ugly".A review of the literature and clinical case analysis were conducted to explore the clinical implications,management strategies,and the system's application in endoscopic practice.Good polyps,mainly including fundic gland polyps and inflammatory fibrous polyps,have a low risk of malignancy and typically require minimal or no intervention.Bad polyps,mainly including hyperplastic polyps and adenomas,pose an intermediate risk of malignancy,necessitating closer monitoring or removal.Ugly polyps,mainly including type 3 neuroendocrine tumors and early gastric cancer,indicate a high potential for malignancy and require urgent and comprehensive treatment.The new classification system provides a simplified and practical framework for diagnosing and managing GPs,improving diagnostic accuracy,guiding individualized treatment,and promoting advancements in endoscopic techniques.Despite some challenges,such as the risk of misclassification due to similar endoscopic appearances,this system is essential for the standardized management of GPs.It also lays the foundation for future research into biomarkers and the development of personalized medicine.展开更多
Inflammatory fibroid polyp(IFP) is a rare benign lesion of the gastrointestinal tract. We report a case of computed tomography(CT) imaging finding of a gastric IFP with massive fibrosis. CT scans showed thickening of ...Inflammatory fibroid polyp(IFP) is a rare benign lesion of the gastrointestinal tract. We report a case of computed tomography(CT) imaging finding of a gastric IFP with massive fibrosis. CT scans showed thickening of submucosal layer with overlying mucosal hyperenhancement in the gastric antrum. The submucosal layer showed increased enhancement on delayed phase imaging. An antrectomy with gastroduodenostomy was performed because gastric cancer was suspected, particularly signet ring cell carcinoma. The histopathological diagnosis was an IFP with massive fibrosis. The authors suggest that when the submucosal layer of the gastric wall is markedly thickened with delayed enhancement and preservation of the mucosal layer, an IFP with massive fibrosis should be considered in the differential diagnosis.展开更多
A case of an inflammatory fibroid polyp occurring in the transverse colon and diagnosed by endoscopic biopsy is reported. The patient was an 82-year-old man who visited our hospital for further evaluation of occult bl...A case of an inflammatory fibroid polyp occurring in the transverse colon and diagnosed by endoscopic biopsy is reported. The patient was an 82-year-old man who visited our hospital for further evaluation of occult blood in stool. The Colonoscopy revealed a small, red, and peduncular polyp, about 6 mm in diameter, in the transverse colon. Histological examination of the biopsy specimen obtained from the polyp revealed proliferation of fibroblasts and infiltration of inflammatory cells such as plasma cells and eosinophils. This polyp was diagnosed as an inflammatory fibroid polyp, which can appear in many different locations throughout gastrointestinal tract, though still rare in the transverse colon.展开更多
Inflammatory fibroid polyps (IFP) are a rare benign entity that arises from the submucosa of the gastrointestinal tract and protrudes into the lumen. The clinical presentation depends on the size and localization. The...Inflammatory fibroid polyps (IFP) are a rare benign entity that arises from the submucosa of the gastrointestinal tract and protrudes into the lumen. The clinical presentation depends on the size and localization. They are particularly found in the ileum, where they are frequently present as an ileal intussusception. We report the case of a 56-year-old female patient who presented with periumbilical pain along with multiple episodes of vomiting and chronic constipation. An abdominal CT scan revealed an ileo-ileal intussusception of an endoluminal hypodense lesion with mesenteric lymphadenopathy. Surgical treatment consisted of segmental ileal resection with primary anastomosis. The histopathological analysis revealed an inflammatory fibroid polyp in the ileum. Although these tumors have no malignant potential, surgery is always indicated in ileo-ileal intussusception to ascertain the histological nature of the lesion.展开更多
BACKGROUND An inflammatory fibrotic polyp(IFP)of the gastrointestinal tract is generally considered benign and noninvasive.An IFP in the duodenum is very rare.Here we report the case of an aggressive and infiltrative ...BACKGROUND An inflammatory fibrotic polyp(IFP)of the gastrointestinal tract is generally considered benign and noninvasive.An IFP in the duodenum is very rare.Here we report the case of an aggressive and infiltrative duodenal IFP resembling a malignancy and the patient subsequently underwent surgery.To the best of our knowledge,this is the first case of duodenal IFP invading the subserosa.CASE SUMMARY A 50-year-old female patient presented with recurrent epigastric pain for more than 1 month.Gastroscopy revealed a mass in the duodenal bulb involving the pylorus.Endoscopic ultrasound suggested that the lesion was a hypoechoic mass involving the muscularis propria,and duodenal bulb stromal tumor was considered based on abdominal computed tomography and gastric magnetic resonance imaging findings.A distal gastrectomy was subsequently performed.Based on the histopathology and immunohistochemical results,the lesion was finally diagnosed as duodenal IFP.The patient recovered well after surgery and had no recurrence at the 27-month follow-up.CONCLUSION This duodenal IFP invading subserosa indicates that IFP has specific invasion characteristics,and accurate diagnosis is critical to avoid inadequate treatment.展开更多
Morphologically,an inflammatory fibroid polyp(IFP)is usually centred in the submucosa.Extension of an IFP to the subserosa with destruction of the muscularis propria is exceedingly rare.Herein,we describe a 70-year-ol...Morphologically,an inflammatory fibroid polyp(IFP)is usually centred in the submucosa.Extension of an IFP to the subserosa with destruction of the muscularis propria is exceedingly rare.Herein,we describe a 70-year-old woman who presented with right lower abdominal pain but was finally diagnosed with an IFP.Contrast-enhanced computed tomography revealed a target-like structure with a hypovascular mass at the leading edge,which was consistent with intussusception due to a tumour.Following surgery,the resected specimen displayed a mass measuring 4×3×3 cmthat was protruding into the lumen.Microscopically,the mass was centred in the submucosa,extending up to the mucosal surface and down to the subserosa and serosa.The muscularis mucosae and muscularis propria were destroyed focally.A PDGFRA gene mutation in exon 2(1837_1851 del)that was found in this case,as well as a highly infiltrative growth pattern,strongly supported the neoplastic nature of IFP.展开更多
基金Supported by Shandong Province Traditional Chinese Medicine Science and Technology Youth Project,No:2021Q057.
文摘BACKGROUND Inflammatory fibroid polyps(IFPs)are generally considered as benign and relatively rare mesenchymal gastrointestinal tract tumors.IFPs can occur in any part of the gastrointestinal tract but are most prevalent in the stomach,particularly in the gastric antrum.With a low incidence in clinical practice and a lack of distinct endoscopic features,the preoperative diagnosis rate of IFP is disappointingly low,often leading to missed diagnoses or misdiagnoses.CASE SUMMARY A 43-year-old man,hospitalized with abdominal pain and distension,underwent his first gastroscopy in 2020,which revealed chronic superficial erosive gastritis.From 2021 to 2022,his condition progressed from antral ulcers to a 2.0 cm gastric antrum bulge of an unclear nature.After proton pump inhibitor treatment,the lesion shrank but did not heal completely.Following a thorough assessment using magnifying endoscopy with narrow-band imaging,gastric-enhanced computed tomography,and endoscopic ultrasonography,endoscopic submucosal dissection was performed on the identified lesion.A subsequent postoperative pathological examination conclusively diagnosed the lesion as an IFP.At 6 months follow-up,no recurrence or metastasis was observed,with good mucosal scar healing.CONCLUSION Through using multiple diagnostic and therapeutic test results,an IFP with an unusual morphology could be identified.
文摘BACKGROUND The diagnosis of gastric inflammatory fibroid polyps(IFPs)mainly depends on pathological confirmation after endoscopic or surgical treatment.Gastric IFP have typical manifestations under endoscopic ultrasonography(EUS),but atypical EUS features have also been reported.Previous studies have found that atypical features of gastric IFPs observed under EUS have corresponding histological manifestations.At present,there is no study elaborating the EUS manifestations of gastric IFPs at different pathological stages.We hypothesize that gastric IFPs at different pathological stages may have different EUS features.AIM To describe EUS features of gastric IFPs and compare with their pathological characteristics.METHODS Clinical data of 53 inpatients with pathologically diagnosed gastric IFPs after endoscopic treatment were collected.All patients underwent preoperative EUS.We analyzed the EUS characteristics of the lesions and compared with the pathological characteristics and staging of the resected specimens.RESULTS Most gastric IFPs showed medium-low echo(67.9%),homogeneous echo(90.6%),and unclear boundaries(83%),and involved the second and third layers of the gastric wall(69.8%)under EUS.The echogenicity level and echo homogeneity were significantly correlated with the pathological stage of gastric IFP.Gastric IFPs in the nodular stage presented hypoechoic and homogeneous echo.Gastric IFPs in the fibrovascular stage mostly showed medium-low echo and homogeneous echo.Gastric IFPs in the sclerotic stage showed different echogenicity levels and echo homogeneity.The accuracy of EUS in diagnosing gastric IFPs was 66.0%(35/53),and the accuracy in determining the origin layer of gastric IFPs was 73.4%(39/53).CONCLUSION Gastric IFPs at different pathological stages have different EUS features.In order to improve the diagnostic rate,it is necessary to combine EUS with EUS-guided fine-needle aspiration or artificial intelligence.
文摘Objective: To review the diagnosis and differential diagnosis of inflammatory fibroid polyp (IFP) of gastrointestinal tract. Methods: The clinical symptoms, histopathologic features and immunohistochemical (ABC method) staining in 9 cases were observed. Results: IFP presented either as a solitary pedunculated or sessile lesion arising from the submucosa and protroding into the lumen; composed of a background of fibroblasts and blood vessels infiltrated by a variable number of inflammatory cells, often numerous eosinophilias leukocytes. Immunohistochemical staining: the spindle cells of all cases reacted with Vimentin. The partial cells of several cases react with Actin, NSE, a -AT. 7 cases were follow-up. No patients had a recurrence of the lesion. Conclusion: IFP are rare lesions, and may represent an exaggerated response to inflammatory or other injury process. The prognosis is good when treated by segmental resections of endoscopic removals.
文摘With the widespread use of upper gastrointestinal endoscopy,more and more gastric polyps(GPs)are being detected.Traditional management strategies often rely on histopathologic examination,which can be time-consuming and may not guide immediate clinical decisions.This paper aims to introduce a novel classification system for GPs based on their potential risk of malignant transformation,categorizing them as"good","bad",and"ugly".A review of the literature and clinical case analysis were conducted to explore the clinical implications,management strategies,and the system's application in endoscopic practice.Good polyps,mainly including fundic gland polyps and inflammatory fibrous polyps,have a low risk of malignancy and typically require minimal or no intervention.Bad polyps,mainly including hyperplastic polyps and adenomas,pose an intermediate risk of malignancy,necessitating closer monitoring or removal.Ugly polyps,mainly including type 3 neuroendocrine tumors and early gastric cancer,indicate a high potential for malignancy and require urgent and comprehensive treatment.The new classification system provides a simplified and practical framework for diagnosing and managing GPs,improving diagnostic accuracy,guiding individualized treatment,and promoting advancements in endoscopic techniques.Despite some challenges,such as the risk of misclassification due to similar endoscopic appearances,this system is essential for the standardized management of GPs.It also lays the foundation for future research into biomarkers and the development of personalized medicine.
文摘Inflammatory fibroid polyp(IFP) is a rare benign lesion of the gastrointestinal tract. We report a case of computed tomography(CT) imaging finding of a gastric IFP with massive fibrosis. CT scans showed thickening of submucosal layer with overlying mucosal hyperenhancement in the gastric antrum. The submucosal layer showed increased enhancement on delayed phase imaging. An antrectomy with gastroduodenostomy was performed because gastric cancer was suspected, particularly signet ring cell carcinoma. The histopathological diagnosis was an IFP with massive fibrosis. The authors suggest that when the submucosal layer of the gastric wall is markedly thickened with delayed enhancement and preservation of the mucosal layer, an IFP with massive fibrosis should be considered in the differential diagnosis.
文摘A case of an inflammatory fibroid polyp occurring in the transverse colon and diagnosed by endoscopic biopsy is reported. The patient was an 82-year-old man who visited our hospital for further evaluation of occult blood in stool. The Colonoscopy revealed a small, red, and peduncular polyp, about 6 mm in diameter, in the transverse colon. Histological examination of the biopsy specimen obtained from the polyp revealed proliferation of fibroblasts and infiltration of inflammatory cells such as plasma cells and eosinophils. This polyp was diagnosed as an inflammatory fibroid polyp, which can appear in many different locations throughout gastrointestinal tract, though still rare in the transverse colon.
文摘Inflammatory fibroid polyps (IFP) are a rare benign entity that arises from the submucosa of the gastrointestinal tract and protrudes into the lumen. The clinical presentation depends on the size and localization. They are particularly found in the ileum, where they are frequently present as an ileal intussusception. We report the case of a 56-year-old female patient who presented with periumbilical pain along with multiple episodes of vomiting and chronic constipation. An abdominal CT scan revealed an ileo-ileal intussusception of an endoluminal hypodense lesion with mesenteric lymphadenopathy. Surgical treatment consisted of segmental ileal resection with primary anastomosis. The histopathological analysis revealed an inflammatory fibroid polyp in the ileum. Although these tumors have no malignant potential, surgery is always indicated in ileo-ileal intussusception to ascertain the histological nature of the lesion.
文摘BACKGROUND An inflammatory fibrotic polyp(IFP)of the gastrointestinal tract is generally considered benign and noninvasive.An IFP in the duodenum is very rare.Here we report the case of an aggressive and infiltrative duodenal IFP resembling a malignancy and the patient subsequently underwent surgery.To the best of our knowledge,this is the first case of duodenal IFP invading the subserosa.CASE SUMMARY A 50-year-old female patient presented with recurrent epigastric pain for more than 1 month.Gastroscopy revealed a mass in the duodenal bulb involving the pylorus.Endoscopic ultrasound suggested that the lesion was a hypoechoic mass involving the muscularis propria,and duodenal bulb stromal tumor was considered based on abdominal computed tomography and gastric magnetic resonance imaging findings.A distal gastrectomy was subsequently performed.Based on the histopathology and immunohistochemical results,the lesion was finally diagnosed as duodenal IFP.The patient recovered well after surgery and had no recurrence at the 27-month follow-up.CONCLUSION This duodenal IFP invading subserosa indicates that IFP has specific invasion characteristics,and accurate diagnosis is critical to avoid inadequate treatment.
文摘Morphologically,an inflammatory fibroid polyp(IFP)is usually centred in the submucosa.Extension of an IFP to the subserosa with destruction of the muscularis propria is exceedingly rare.Herein,we describe a 70-year-old woman who presented with right lower abdominal pain but was finally diagnosed with an IFP.Contrast-enhanced computed tomography revealed a target-like structure with a hypovascular mass at the leading edge,which was consistent with intussusception due to a tumour.Following surgery,the resected specimen displayed a mass measuring 4×3×3 cmthat was protruding into the lumen.Microscopically,the mass was centred in the submucosa,extending up to the mucosal surface and down to the subserosa and serosa.The muscularis mucosae and muscularis propria were destroyed focally.A PDGFRA gene mutation in exon 2(1837_1851 del)that was found in this case,as well as a highly infiltrative growth pattern,strongly supported the neoplastic nature of IFP.
