BACKGROUND Duodenal Brunner's gland hyperplasia(BGH)is a therapeutic target when complications such as bleeding or gastrointestinal obstruction occur or when malignancy cannot be ruled out.Herein,we present a case...BACKGROUND Duodenal Brunner's gland hyperplasia(BGH)is a therapeutic target when complications such as bleeding or gastrointestinal obstruction occur or when malignancy cannot be ruled out.Herein,we present a case of large BGH treated with endoscopic mucosal resection(EMR).CASE SUMMARY An 83-year-old woman presented at our hospital with dizziness.Blood tests revealed severe anemia,esophagogastroduodenoscopy showed a 6.5 cm lesion protruding from the anterior wall of the duodenal bulb,and biopsy revealed the presence of glandular epithelium.Endoscopic ultrasonography(EUS)demonstr-ated relatively high echogenicity with a cystic component.The muscularis propria was slightly elevated at the base of the lesion.EMR was performed without complications.The formalin-fixed lesion size was 6 cm×3.5 cm×3 cm,showing nodular proliferation of non-dysplastic Brunner's glands compartmentalized by fibrous septa,confirming the diagnosis of BGH.Reports of EMR or hot snare polypectomy are rare for duodenal BGH>6 cm.In this case,the choice of EMR was made by obtaining information on the base of the lesion as well as on the internal characteristics through EUS.CONCLUSION Large duodenal lesions with good endoscopic maneuverability and no evident muscular layer involvement on EUS may be resectable via EMR.展开更多
Cystic Brunner's gland hamartoma in the duodenum is exceedingly rare,although microscopic examination may sometimes reveal a Brunner's gland hamartoma containing dilated ducts in the duodenum.We present a case...Cystic Brunner's gland hamartoma in the duodenum is exceedingly rare,although microscopic examination may sometimes reveal a Brunner's gland hamartoma containing dilated ducts in the duodenum.We present a case of large cystic Brunner's gland hamartoma in the duodenum with a long stalk,which is described in light of multidetector-row computed tomography,magnetic resonance imaging,and a modified small bowel series,together with pathologic correlation and differential diagnosis.展开更多
BACKGROUND Brunner’s gland hyperplasia(BGH)is a rare benign lesion of the duodenum.Lipomatous pseudohypertrophy(LiPH)of the pancreas is an extremely rare disease.Because each condition is rare,the probability of pure...BACKGROUND Brunner’s gland hyperplasia(BGH)is a rare benign lesion of the duodenum.Lipomatous pseudohypertrophy(LiPH)of the pancreas is an extremely rare disease.Because each condition is rare,the probability of purely coincidental coexistence of both conditions is extremely low.CASE SUMMARY We report a 26-year-old man presenting to our hospital with symptoms of recurrent upper gastrointestinal bleeding.Upper gastrointestinal endoscopy showed a huge pedunculated polypoid lesion in the duodenum with bleeding at the base of the lesion.Histopathological examination of the duodenal biopsy specimens showed BGH.Besides,abdominal computed tomography and magnetic resonance imaging revealed marked fat replacement over the entire pancreas,confirmed by histopathological evaluation on percutaneous pancreatic biopsies.Based on the radiological and histological findings,LiPH of the pancreas and BGH were diagnosed.The patient refused any surgical intervention.Therefore,he was managed with supportive treatment.The patient’s symptoms improved and there was no further bleeding.CONCLUSION This is the first well-documented case showing the coexistence of LiPH of the pancreas and BGH.展开更多
Diffuse intestinal ganglioneuromatosis is a hamartomatous polyposis characterized by a disseminated, intramural or transmural proliferation of neural elements involving the enteric plexuses. It has been associated wit...Diffuse intestinal ganglioneuromatosis is a hamartomatous polyposis characterized by a disseminated, intramural or transmural proliferation of neural elements involving the enteric plexuses. It has been associated with MEN Ⅱ, neurofibromatosis type 1 and hamartomatous polyposis associated with phosphatase and tensin homolog mutation. We report the case of a female patient with a history of a breast and endometrial tumor who presented in a colonoscopy performed for rectal bleeding diffuse ganglioneuromatosis, which oriented the search for other characteristic findings of Cowden syndrome given the personal history of the patient. The presence of an esophagogastric polyposis was also noted. Cowden syndrome is characterized by skin lesions, but it is rarely diagnosed by these lesions, because they are usually overlooked. Intestinal polyposis is not a major diagnostic criterion but it is very useful for early diagnosis. The combination of colonic polyposis and glucogenic acanthosis should orient the diagnosis to Cowden syndrome.展开更多
Brunner’s gland adenoma is a rare tumour of the duodenum,which is usually benign.A 71-year-old woman presenting with epigastric pain,upper gastro-intestinal haemorrhage and melaena was reported in this paper.Upper ga...Brunner’s gland adenoma is a rare tumour of the duodenum,which is usually benign.A 71-year-old woman presenting with epigastric pain,upper gastro-intestinal haemorrhage and melaena was reported in this paper.Upper gastro-intestinal(GI)endoscopy revealed a large pedunculated tumour on the superior part of the duodenal bulb.Endoscopic polypectomy was successfully performed by clipping and nylon thread without any com-plications.Histological examination revealed a Brunner’s gland adenoma.展开更多
文摘BACKGROUND Duodenal Brunner's gland hyperplasia(BGH)is a therapeutic target when complications such as bleeding or gastrointestinal obstruction occur or when malignancy cannot be ruled out.Herein,we present a case of large BGH treated with endoscopic mucosal resection(EMR).CASE SUMMARY An 83-year-old woman presented at our hospital with dizziness.Blood tests revealed severe anemia,esophagogastroduodenoscopy showed a 6.5 cm lesion protruding from the anterior wall of the duodenal bulb,and biopsy revealed the presence of glandular epithelium.Endoscopic ultrasonography(EUS)demonstr-ated relatively high echogenicity with a cystic component.The muscularis propria was slightly elevated at the base of the lesion.EMR was performed without complications.The formalin-fixed lesion size was 6 cm×3.5 cm×3 cm,showing nodular proliferation of non-dysplastic Brunner's glands compartmentalized by fibrous septa,confirming the diagnosis of BGH.Reports of EMR or hot snare polypectomy are rare for duodenal BGH>6 cm.In this case,the choice of EMR was made by obtaining information on the base of the lesion as well as on the internal characteristics through EUS.CONCLUSION Large duodenal lesions with good endoscopic maneuverability and no evident muscular layer involvement on EUS may be resectable via EMR.
文摘Cystic Brunner's gland hamartoma in the duodenum is exceedingly rare,although microscopic examination may sometimes reveal a Brunner's gland hamartoma containing dilated ducts in the duodenum.We present a case of large cystic Brunner's gland hamartoma in the duodenum with a long stalk,which is described in light of multidetector-row computed tomography,magnetic resonance imaging,and a modified small bowel series,together with pathologic correlation and differential diagnosis.
基金Supported by School of Medicine and Pharmacy,Vietnam National University Hanoi,Hanoi,Viet Nam,No.QGSP.2021.06.
文摘BACKGROUND Brunner’s gland hyperplasia(BGH)is a rare benign lesion of the duodenum.Lipomatous pseudohypertrophy(LiPH)of the pancreas is an extremely rare disease.Because each condition is rare,the probability of purely coincidental coexistence of both conditions is extremely low.CASE SUMMARY We report a 26-year-old man presenting to our hospital with symptoms of recurrent upper gastrointestinal bleeding.Upper gastrointestinal endoscopy showed a huge pedunculated polypoid lesion in the duodenum with bleeding at the base of the lesion.Histopathological examination of the duodenal biopsy specimens showed BGH.Besides,abdominal computed tomography and magnetic resonance imaging revealed marked fat replacement over the entire pancreas,confirmed by histopathological evaluation on percutaneous pancreatic biopsies.Based on the radiological and histological findings,LiPH of the pancreas and BGH were diagnosed.The patient refused any surgical intervention.Therefore,he was managed with supportive treatment.The patient’s symptoms improved and there was no further bleeding.CONCLUSION This is the first well-documented case showing the coexistence of LiPH of the pancreas and BGH.
文摘Diffuse intestinal ganglioneuromatosis is a hamartomatous polyposis characterized by a disseminated, intramural or transmural proliferation of neural elements involving the enteric plexuses. It has been associated with MEN Ⅱ, neurofibromatosis type 1 and hamartomatous polyposis associated with phosphatase and tensin homolog mutation. We report the case of a female patient with a history of a breast and endometrial tumor who presented in a colonoscopy performed for rectal bleeding diffuse ganglioneuromatosis, which oriented the search for other characteristic findings of Cowden syndrome given the personal history of the patient. The presence of an esophagogastric polyposis was also noted. Cowden syndrome is characterized by skin lesions, but it is rarely diagnosed by these lesions, because they are usually overlooked. Intestinal polyposis is not a major diagnostic criterion but it is very useful for early diagnosis. The combination of colonic polyposis and glucogenic acanthosis should orient the diagnosis to Cowden syndrome.
文摘Brunner’s gland adenoma is a rare tumour of the duodenum,which is usually benign.A 71-year-old woman presenting with epigastric pain,upper gastro-intestinal haemorrhage and melaena was reported in this paper.Upper gastro-intestinal(GI)endoscopy revealed a large pedunculated tumour on the superior part of the duodenal bulb.Endoscopic polypectomy was successfully performed by clipping and nylon thread without any com-plications.Histological examination revealed a Brunner’s gland adenoma.