To summarize the clinicopathological and endoscopic characteristics and treatment outcome of pyloric gland adenoma (PGA) in gastrointestinal tract.

14 patients who were pathologically diagnosed as PGA in gastrointestinal tract in Beijing Friendship Hospital, Capital Medical University was retrospectively analyzed.

Among the 14 patients, nine were female (64.3%) and five were male (35.7%), with the median age of 63 years old (range, 40 to 78 years).All 14 PGAs were solitary, with the average maximum diameter of 19 mm (range, 4-45 mm).Ten lesions located in the stomach (71.4%) (including six lesions in gastric body, three lesions in the fundus and one lesion in the antrum) and four lesions in the duodenal bulb (28.6%). Most patients were asymptomatic.Endoscopically, according to Paris classification, ten lesions (71.4%) were classified as type 0-I, three lesions (21.4%) as type 0-Ⅱa, and one lesion (7.1%) as type 0-Ⅱb.Regarding the background mucosa, among the ten gastric PGAs, five cases were autoimmune gastritis, four cases were Helicobacter Pylori-associated gastritis, and one case was familial adenomatous polyposis; meanwhile ectopic gastric mucosa was found around all the four duodenal PGAs. In terms of treatment, 12 cases (85.7%) were treated with endoscopic resection, all of which were completely resected without any serious complications. Histologically, PGAs were composed of compact tubules of pyloric phenotype, wherein five cases (35.7%) were accompanied by high-grade dysplasia.All PGAs expressed MUC6 and co-expressed MUC5AC.

PGAs in gastrointestinal tract were frequently found in the background mucosa of autoimmune gastritis, Helicobacter Pylori-associated gastritis and ectopic gastric mucosa.They were mostly asymptomatic and more common in elderly women. There were no specific endoscopic manifestations, so endoscopists and pathologists need to improve their recognition of PGA.Early diagnosis and endoscopic treatment can lead to a good prognosis.