Giant gastric polyp

  • Giant gastric polyp Figure


A 73-year-old man with atrial fibrillation on antithrombotic therapy and congestive heart failure presents with weight loss and iron deficiency anemia. He undergoes bidirectional endoscopy and video capsule endoscopy that reveal only this large polyp in the stomach. The polyp is described as sessile, smooth, and lobulated and is located along the greater curvature and posterior gastric wall. Biopsies suggest a benign hyperplastic polyp, but given the size, the patient is referred for resection. Pathology returns as a hamartomatous polyp. What polyposis syndrome is this type of polyp usually associated with?

Familial adenomatous polyposis syndrome Peutz-Jeghers syndrome MUTYH-associated polyposis Gardner syndrome
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The underwater leather bottle

A 70-year-old man presents with weight loss, anorexia, and nausea. A CT scan shows a significantly thickened gastric wall. Upper endoscopy and mucosal biopsies are performed from hyperemic, “angry-looking” areas, but malignancy is not discerned. A repeat endoscopy is performed, and the lumen is submerged in water. A specialized stiff cold snare is used to obtain sampling underwater. Histopathologic evaluation also is performed (Figure). Which of the following is true about this condition?
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Pesky pearls

A 73-year-old man presents with right upper quadrant pain 19 months after cholecystectomy. A CT scan shows perihepatic fluid collection extending to the gallbladder fossa suspicious for biloma. Percutaneous drainage is performed, and evidence of dropped gallstones is found during placement. After multidisciplinary discussion, cholangioscopy is completed through the percutaneous tract with removal of the dropped gallstones. Which of the following is true?
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