Autoimmune Gastritis Associated With a Gastric Hyperplastic Polyp: Two Case Reports and Review of its Neoplastic Potential

Autoimmune gastritis (AIG) results in the loss of oxyntic glands, achlorhydria, and hypergastrinemia and frequently leads to the development of gastric hyperplastic polyps (GHPs). AIG is increasingly being recognized as a major contributor to corpus-dominant atrophy in East Asia. Despite its increasing prevalence, it is frequently underdiagnosed in clinical practice. Although GHPs are typically benign, AIG is associated with an elevated risk of gastric cancer, including neuroendocrine tumors. Herein, we report two cases in which GHPs detected during screening endoscopy led to AIG identification. Both of the patients were negative for Helicobacter pylori and tested positive for antiparietal cell antibodies. Histological examination confirmed oxyntic atrophy and hyperplastic polyps, without any evidence of dysplasia. These case reports have highlighted that GHPs may develop in the context of H. pylori-associated gastritis as well as from autoimmune causes, thus emphasizing the importance of recognizing and assessing AIG during endoscopic screening. The possibility of coexisting AIG should be considered in individuals with GHPs. Accordingly, clinicians are advised to evaluate AIG when GHPs are detected in a background of corpus-dominant atrophy, as delayed recognition may miss the opportunity to identify a precancerous risk.