Which of the following statements about gastric polyps is/are true?

D. In a given patient, multiple polyps are generally of a single histologic type.

E. Gastric adenomatous polyps greater than 2 cm. in diameter should be excised because of the risk of malignant transformation.

DISCUSSION: As early as 1895 Hauser reported an association between familial adenomatous polyposis of the colon and multiple gastric polyps. This early association may have given rise not only to the confusing nomenclature of gastric polyps but also to the mistaken notion that they are analogous to colorectal polyps in microscopic appearance and natural history. Unlike colonic polyps, gastric epithelial polyps are very uncommon tumors (prevalence 0.4% to 0.8%). Their histologic appearance cannot be predicted on the basis of location in the stomach, although the endoscopic literature is beginning to define predictive algorithms based on location and ultrasound. Multiple polyps are almost always of a single histologic type. Gastric adenomatous polyps have long been associated with adenocarcinoma. This association is directly related to the size of the polyps. Up to 24% of polyps 2 cm. or greater in diameter are associated with adenocarcinoma. In contrast, only 4% of polyps with a diameter less than 2 cm. are associated with carcinoma. The risk, if any, of carcinoma in patients with hyperplastic polyps appears to be associated with the atrophic gastritis that frequently accompanies them rather than with the polyps themselves.