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Gastric neoplasm with foveolar-cell differentiation in Helicobacter pylori-naïve patients

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dc.contributor.authorKotaro Shibagaki
dc.contributor.authorRyoji Kushima
dc.contributor.authorTsuyoshi Mishiro
dc.contributor.authorKenichi Kishimoto
dc.contributor.authorYusuke Takahashi
dc.contributor.authorNorihisa Ishimura
dc.contributor.authorAsuka Araki
dc.contributor.authorMamiko Nagase
dc.contributor.authorDaisuke Niino
dc.contributor.authorShunji Ishihara
dc.contributor.authorSatoshi Kotani
dc.contributor.departmentBiología Celular e Histología
dc.contributor.editorUniversidad de Murcia, Departamento de Biologia Celular e Histiologia
dc.date.accessioned2026-02-16T09:36:11Z
dc.date.available2026-02-16T09:36:11Z
dc.date.issued2026
dc.description.abstractThe incidence of Helicobacter pylori (Hp) naïve gastric neoplasms (HpNGNs) is increasing due to a growing Hp-naïve population and improved recognition. Among these, HpNGNs that predominantly exhibit foveolar-cell differentiation include foveolar-type gastric adenomas (FGA) and fundic gland polyps with dysplasia (FGPD). Traditionally, FGAs have been considered large, whitish, flat lesions (flat-type FGA), primarily associated with syndromic conditions, such as familial adenomatous polyposis (FAP) and gastric adeno carcinoma and proximal polyposis of the stomach (GAPPS), while sporadic cases are rare. This type exhibits a gastric immunophenotype with diverse differentiation, mainly toward foveolar cells, and harbors APC and KRAS mutations in all sporadic and most syndromic cases. A distinct subset of FGAs, termed foveolar-type gastric adenoma with a raspberry-like appearance (FGA RA), has been identified. It presents as small, reddish polyps with unique macroscopic and microscopic features and only occurs sporadically. FGA-RA often mimics gastric hyperplastic polyps macroscopically and typically exhibits low-grade dysplasia, making biopsy based diagnosis challenging and leading to its historical underrecognition. It shows pure foveolar differentiation and consistently harbors Krüppel-like factor 4 (KLF4) mutations. FGPD primarily develops sporadically in Hp-naïve individuals with long-term proton pump inhibitor use. A syndromic form, resembling flat-type FGAs, is also associated with FAP and GAPPS. Histologically, FGPD features dysplasia confined to the superficial foveolar epithelium and mucus neck cells overlying fundic gland polyps, with APC mutations detected in approximately 50% of cases. This review explores the clinicopathological and molecular characteristics of HpNGNs with predominant foveolar cell differentiation, emphasizing the need for an updated histological diagnostic framework
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dc.format.extent13
dc.identifier.doihttps://doi.org/10.14670/HH-18-966
dc.identifier.eissn1699-5848
dc.identifier.issn0213-3911
dc.identifier.urihttp://hdl.handle.net/10201/205501
dc.languageeng
dc.relationUniversidad de Murcia, Departamento de Biologia Celular e Histiologia
dc.relationSin financiación externa a la Universidad
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International*
dc.rights.accessRightsinfo:eu-repo/semantics/openAccess
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectGastric adenoma
dc.subjectGastric dysplasia
dc.subjectFoveolar-type
dc.subjectFundic gland polyp
dc.subjectHelicobacter pylori
dc.subject.odsNo relacionado con ningún objetivo de desarrollo sostenible
dc.titleGastric neoplasm with foveolar-cell differentiation in Helicobacter pylori-naïve patients
dc.typeinfo:eu-repo/semantics/article
dspace.entity.typePublication
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Histology and histopathology, Vol.41, Nº3, (2026)