LAUSR

Lobular capillary hemangioma, known as pyogenic granuloma, is a benign vascular tumor that generally appears on the skin or in the oral cavity but rarely occurs in the gastrointestinal tract, where it can cause bleeding [1]. Although gastric pyogenic granuloma is rarely reported in the literature, (up to 2016, approximately 50 cases of gastrointestinal pyogenic granuloma in the English literature had been indexed on MEDLINE, including a few cases of gastric involvement), the actual incidence is probably higher [2, 3]. The endoscopic appearance of pyogenic granuloma is usually a single polypoid lesion, smooth and ulcerated; the color ranges from bluish to reddish with a superficial white or opaque film covering. Resection of pyogenic granuloma is necessary in patients with anemia, but postresection bleeding is a potential complication. The lesions typically involve the mucosa but may extend to the deep layers; thus, preoperative endoscopic ultrasonography is recommended [1, 4, 5]. Histopathologically, pyogenic granuloma is a hemangioma characterized by a lobule-like growth of capillaries with enlarged vascular endothelial cells and inflammatory cell infiltration in the stroma. Granulation tissue may also be present; the main pathological differential diagnosis of pyogenic granuloma includes bacillary angiomatosis, Kaposi’s sarcoma, or inflammatory and/or hyperplastic polyps [1, 3]. We report a case of a 78 year-old Caucasian woman with a medical history significant for ibuprofen use admitted to our department for anemia and melena requiring transfusion. Esophagogastroduodenoscopy revealed a nearly 20-mm pedunculated polyp, strongly hyperemic with a superficial white film, in the gastric body (▶Fig. 1). Endoscopic ultrasonograE-Videos