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1.
Niger J Clin Pract ; 22(9): 1298-1300, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31489870

RESUMO

Brunner's gland adenoma is usually asymptomatic and sometimes accompanied by nausea, vomiting and swelling. It is often confused with duodenal malignancy, which may mislead and the physician about its treatment. We want to present a case of a 40-year-old female with a history of weight loss, vomiting and nausea since six months. Initial imaging studies that revealed a large mass in the duodenum and endoscopic findings that suggested duodenal invagination. Whipple operation had been recommended to the patient by two different general surgery departments. The patient reported to our clinic for gastroenterological evaluation before the operation. At our exmination, a giant polyp, 5 to 6 cm in size, was observed in the second part of the duodenum; it was 9 to 10 cm long and originated from the pylorus. Duodenotomy was performed, and only the giant polyp was removed. Pathological examination revealed hyperplastic Brunner's glands mixed with fibromuscular tissue and mature fat tissue.


Assuntos
Adenoma/patologia , Glândulas Duodenais/patologia , Neoplasias Duodenais/cirurgia , Duodenoscopia , Duodeno/diagnóstico por imagem , Piloro/diagnóstico por imagem , Adenoma/cirurgia , Adulto , Glândulas Duodenais/cirurgia , Neoplasias Duodenais/patologia , Feminino , Humanos , Resultado do Tratamento
2.
BMC Gastroenterol ; 19(1): 151, 2019 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-31443637

RESUMO

BACKGROUND: With the development and application of endoscopic technology, most pedunculated polyps can be absolutely resected with a complete specimen by hot snare polypectomy (HSP). Brunner's gland hamartoma (BGH) is a rare benign small bowel tumor. The majority of BGH measuring about 2 cm in diameter, rarely larger than 5 cm. Most patients are asymptomatic, some may present with gastrointestinal hemorrhage or intestinal obstruction. Symptomatic larger lesions leading to bleeding or obstruction should be excised either endoscopically or surgically. Whether it is safe and effective that removing a BGH measuring about 7 cm by HSP is not known. CASE PRESENTATION: Here, we reported a rare case of a proximal duodenum pedunculated mass measuring about 7 cm which was responsible for the patient's severe anemia. we treated it as a pedunculated polyp. After being pretreated the stalk with an endoloop which was placed around the base of the mass to prevent post-polypectomy bleeding (PPB), the pedunculated BGH was removed by HSP completely. The stalk of the mass was negative. We achieved a curative resection. CONCLUSION: It is a safe and effective for our patient to treat the pedunculated BGH measuring about 7 cm as a pedunculated polyp and remove it by HSP. And future prospective studies in larger cohorts are needed to confirm it.


Assuntos
Glândulas Duodenais/patologia , Duodenopatias , Endoscopia/métodos , Hamartoma , Pólipos Intestinais , Dissecação/métodos , Duodenopatias/patologia , Duodenopatias/fisiopatologia , Duodenopatias/cirurgia , Feminino , Hamartoma/patologia , Hamartoma/fisiopatologia , Hamartoma/cirurgia , Humanos , Pólipos Intestinais/patologia , Pólipos Intestinais/fisiopatologia , Pólipos Intestinais/cirurgia , Pessoa de Meia-Idade , Resultado do Tratamento , Carga Tumoral
3.
Acta Gastroenterol Belg ; 82(2): 257-260, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31314185

RESUMO

It has recently been shown that duodenal foveolar gastric metaplasia (FGM) sometimes presents as a polyp. The mechanism by which FGM develops into a polypoid lesion is unknown and it is unclear whether this form of FGM is indistinguishable from other polypoid lesions or whether endoscopists do not recognize it because they are unfamiliar with it. We identified and retrieved archival cases of FGM endoscopically suspicious for adenomatous polyp and examined their pathological, clinical and endoscopic features. Endoscopic features of the 13 identified FGMs presenting as polyps were heterogeneous and overlapping with those of adenomatous polyps. FGM was frequently associated with mucosal and submucosal Brunner's glands, but defining and recognizing hyperplasia of these glands remains difficult. Other pathological features could not explain the development of a polypoid lesion. The endoscopic features of FGM polyps are non-specific, overlapping with those of adenomatous polyps. FGM polyps probably acquire their polypoid aspect due to association with Brunner's gland hyperplasia (BGH), which also arises due to chronic inflammation and damage. Because BGH is ill-defined and difficult to recognize, while FGM is diagnosed easily, this type of polypoid lesions has until now only been recognized based on the presence of FGM, although FGM is most likely a secondary phenomenon and not the primary cause of the polyp.


Assuntos
Glândulas Duodenais/diagnóstico por imagem , Úlcera Duodenal/patologia , Endoscopia do Sistema Digestório , Hamartoma/patologia , Pólipos Intestinais , Metaplasia , Glândulas Duodenais/patologia , Duodenopatias/diagnóstico por imagem , Duodenopatias/patologia , Hamartoma/diagnóstico por imagem , Humanos , Pólipos Intestinais/diagnóstico por imagem , Pólipos Intestinais/patologia , Metaplasia/diagnóstico por imagem , Metaplasia/patologia
5.
JNMA J Nepal Med Assoc ; 57(215): 50-52, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31080246

RESUMO

Brunner's gland adenoma is a rare benign tumor of small bowel, often incidentally discovered during endoscopy or radiological imaging. Mostly they are asymptomatic or often present with nonspecific symptoms such as nausea, vomiting, gastrointestinal hemorrhage, iron deficiency anemia. We reported a 76 years old male case presented with chief complaints of vomiting and black tarry stool. General physical examination was normal except mild tenderness over epigastrium. Esophagogastroduodenoscopy revealed a pedunculated polypoid tubular structure with blind end distally of length approximately 10-12* 3.5*1.5 cm in the second section of the duodenum with multiple skipped ulcers on the exposed surface of it. Additionally, there were few erosions in the duodenum proximally and multiple superficial ulcerations in the antrum, associated with helicobacter pylori confirmed by rapid urease test kit. Surgical or endoscopic excision is the treatment of choice. We consider our case is the eldest case among Brunner's gland adenoma case in literature. Keywords: Brunner's gland adenoma; Brunner's gland hamartoma; Brunner's gland hyperplasia; case report.


Assuntos
Adenoma/diagnóstico , Glândulas Duodenais/patologia , Neoplasias Duodenais/diagnóstico , Hemorragia Gastrointestinal/etiologia , Adenoma/patologia , Idoso , Neoplasias Duodenais/patologia , Endoscopia do Sistema Digestório , Humanos , Masculino , Vômito/etiologia
6.
Indian J Pathol Microbiol ; 62(2): 290-292, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30971558

RESUMO

Brunner's gland hamartomas (BGHs) are uncommon lesions of duodenum which show hyperplasia of these glands along with smooth muscle bundles, adipose tissue and lymphoid aggregates. These are usually benign, solitary, pedunculated, polypoidal lesions. Dysplastic changes in BGH are extremely rare and even rarer is the multiplicity of this lesion. We hereby report an index case of BGH showing features of high-grade dysplasia, presenting as multiple duodenal polyps.


Assuntos
Glândulas Duodenais/patologia , Duodenopatias/diagnóstico , Hamartoma/diagnóstico , Pólipos/patologia , Duodeno/diagnóstico por imagem , Duodeno/patologia , Mucosa Gástrica/patologia , Hamartoma/patologia , Humanos , Hiperplasia , Masculino , Pancreaticoduodenectomia , Tomografia Computadorizada por Raios X , Adulto Jovem
9.
Pan Afr Med J ; 29: 78, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29875959

RESUMO

Brunner's Gland Adenoma is a very rarely seen benign tumor of duodenum. While it generally leads to obstruction and bleeding complaints, it may very rarely occur by mimicking a pancreatic tumor. A 48 years old male patient admitted to the gastroenterology clinic due to the epigastric pain spreading dorsally. No significant feature is present in his clinical history. A lesion containing cystic solid components in the size of 30x40 mm was detected in the head of pancreas as a result of the abdominal tomography. In the light of these findings, pancreaticoduodenectomy is applied to the patient. It is observed that tumor is in submucosal location and widely invaded the pancreatic head. In the histopathological examination, Brunner's Gland Adenoma is reported in pancreatic head localization. In this manuscript a case of Brunner's gland adenoma diagnosed by performing pancreaticoduodenectomy due to the mass in the head of the pancreas is presented.


Assuntos
Adenoma/diagnóstico , Glândulas Duodenais/patologia , Neoplasias Duodenais/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Adenoma/patologia , Adenoma/cirurgia , Glândulas Duodenais/cirurgia , Neoplasias Duodenais/patologia , Neoplasias Duodenais/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Pancreaticoduodenectomia/métodos , Tomografia Computadorizada por Raios X
10.
G Chir ; 39(2): 111-113, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29694312

RESUMO

AIM: To report a case of Brunner's gland hamartoma (BGH) in patient treated with surgical resection. CASE REPORT: A 73 years old male patient that was admitted with melena. The preoperative investigations suggested a suspected duodenal large polypoidal mass. A local resection was performed. Surgical resection is actually considered the best treatment for this lesion. DISCUSSION: Brunner's glands were first described by Brunner in 1688. Hamartoma designates an excessive focal overgrowth of mature normal cells and tissues, composed of identical cellular elements. Most patients with Brunner's gland hamartoma are asymptomatic or have nonspecific complaints. CONCLUSION: BHG is a rare tumor arising from the Brunner's gland of the duodenum, considered entirely benign, although there have been occasionally reports of malignant foci inside.


Assuntos
Glândulas Duodenais/cirurgia , Hamartoma/cirurgia , Idoso , Glândulas Duodenais/patologia , Duodenopatias/complicações , Duodenopatias/cirurgia , Hamartoma/complicações , Humanos , Masculino , Melena/etiologia
11.
Clin J Gastroenterol ; 11(5): 391-395, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29605945

RESUMO

This case involved an 80-year-old man. Screening with esophagogastroduodenoscopy (EGD) in 2004 revealed Brunner's gland hyperplasia (BGH), 5 mm in size, in the duodenal bulb. The size of the lesion increased and its shape has changed since then, as detected in subsequent EGDs. The lesion had increased in size to 15 mm with a depression and biopsy specimens revealed an adenocarcinoma. The patient underwent endoscopic mucosal resection. Histopathological assessments indicated an adenocarcinoma arising from gastric foveolar metaplasia (GFM) adjacent to BGH. BGH stained positive for MUC6, and GFM and the adenocarcinoma stained positive for MUC5AC. Mutations of the GNAS gene were not detected in the GFM biopsied in 2007. On the other hand, common GNAS mutations (R201H) were detected in GFM and the adenocarcinoma in the endoscopically resected specimen in 2013. Moreover, mutant allele frequencies were higher in the carcinoma than in GFM. The patient remains disease-free for 4 years after endoscopic treatment. This case report further supports the notion that GFM may be a precursor lesion in the process of GNAS-mutated, gastric-type duodenal carcinogenesis.


Assuntos
Adenocarcinoma/genética , Adenocarcinoma/patologia , Glândulas Duodenais/patologia , Cromograninas/genética , Neoplasias Duodenais/genética , Neoplasias Duodenais/patologia , Subunidades alfa Gs de Proteínas de Ligação ao GTP/genética , Neoplasias Gástricas/genética , Neoplasias Gástricas/patologia , Adenocarcinoma/cirurgia , Idoso de 80 Anos ou mais , Neoplasias Duodenais/cirurgia , Ressecção Endoscópica de Mucosa , Humanos , Hiperplasia , Masculino , Mutação , Neoplasias Gástricas/cirurgia
15.
Korean J Gastroenterol ; 70(3): 141-144, 2017 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-28934830

RESUMO

Sporadic non-ampullary duodenal adenoma is uncommon and found incidentally during endoscopic examinations. Brunner's gland hyperplasia is commonly encountered during endoscopic examinations. Adenomas arising from Brunner's gland hyperplasia originate from the glandular cells, and the surface epithelia are usually intact. Little has been reported on adenomas originating from the surface epithelium that overrides Brunner's gland hyperplasia. Here, we report a case of a sporadic non-ampullary duodenal adenoma overriding the cystic dilatation of Brunner's gland hyperplasia.


Assuntos
Adenoma/diagnóstico , Glândulas Duodenais/patologia , Neoplasias Duodenais/diagnóstico , Hiperplasia/diagnóstico , Adenoma/metabolismo , Adenoma/patologia , Neoplasias Duodenais/metabolismo , Neoplasias Duodenais/patologia , Duodenoscopia , Duodeno/diagnóstico por imagem , Endossonografia , Humanos , Masculino , Pessoa de Meia-Idade
16.
Pathology ; 49(5): 476-478, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28663083

RESUMO

Brunner's gland cysts are rare, benign lesions of the duodenum usually seen as incidental, polypoid or cystic lesions of the duodenum. We present a series of 25 cases of Brunner's gland cyst, the largest case series to date. All the cases were identified during endoscopic assessment for unrelated causes. The mean age of the patients was 66.2 years and the sex ratio was approximately equal. Most were detected as a small (3-10 mm) polypoid lesion in the second part of the duodenum, away from the ampulla. Most of the cysts were unilocular and all were lined by undulating, cytologically bland cuboidal to columnar cells with clear cytoplasm and small, basal nuclei. No mitotic activity or proliferative activity was seen. No recurrence was noted, despite incomplete removal in many cases. We agree with the hypothesis that Brunner's gland cysts are likely to be caused by local obstruction to the draining duct of Brunner's glands.


Assuntos
Glândulas Duodenais/patologia , Cistos/patologia , Duodenopatias/patologia , Idoso , Idoso de 80 Anos ou mais , Duodeno/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
18.
Rev Esp Enferm Dig ; 109(5): 379, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28480732

RESUMO

A 68-year-old female patient with a past medical history of chronic gastritis underwent an upper endoscopy for surveillance. A ring appearing-like structure recovered from normal mucosa was found in the duodenum bulb. Histology demonstrated Brunner's gland hyperplasia without dysplasia or malignancy.


Assuntos
Glândulas Duodenais/patologia , Endoscopia Gastrointestinal , Idoso , Glândulas Duodenais/diagnóstico por imagem , Feminino , Humanos , Hiperplasia
19.
BMJ Case Rep ; 20172017 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-28275018

RESUMO

A man aged 65 years presented with symptomatic anaemia without overt gastrointestinal bleeding. An oesophagogastroduodenoscopy (EGD) was performed and he was found to have a large ulcerated pedunculated Brunner's gland hamartoma in the duodenal bulb. The polyp was resected using snare cautery in forward and retroflexed positions. Colonoscopy was also performed and a few diminutive polyps were resected. A year later, the patient returned for a surveillance EGD, and no residual polyp was noted. Haemoglobin and iron studies normalised within a few months after polypectomy, with resolution of symptoms.


Assuntos
Glândulas Duodenais/patologia , Pólipos do Colo/cirurgia , Duodenopatias/etiologia , Hamartoma/etiologia , Idoso , Anemia Ferropriva , Glândulas Duodenais/cirurgia , Pólipos do Colo/diagnóstico , Duodenopatias/patologia , Duodenopatias/cirurgia , Hamartoma/patologia , Hamartoma/cirurgia , Humanos , Masculino , Resultado do Tratamento
20.
Diagn Interv Imaging ; 98(10): 663-675, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28185840

RESUMO

Recent advances in imaging have resulted in marked changes in the investigation of the duodenum, which still remains primarily evaluated with videoendoscopy. However, improvements in computed tomography (CT) and magnetic resonance (MR) imaging have made detection and characterization of duodenal mass-forming abnormalities easier. The goal of this pictorial review was to illustrate the most common conditions of the duodenum that present as mass-forming lesions with a specific emphasis on CT and MR imaging. MR imaging used in conjunction with duodenal distension appears as a second line imaging modality for the characterization of duodenal mass-forming lesions. CT remains the first line imaging modality for the detection and characterization of a wide range of duodenal mass-forming lesions.


Assuntos
Duodenopatias/diagnóstico por imagem , Duodeno/diagnóstico por imagem , Adenocarcinoma/diagnóstico por imagem , Adenoma/diagnóstico por imagem , Malformações Arteriovenosas/diagnóstico por imagem , Glândulas Duodenais/diagnóstico por imagem , Glândulas Duodenais/patologia , Coristoma/diagnóstico por imagem , Divertículo/diagnóstico por imagem , Duodeno/anatomia & histologia , Tumores do Estroma Gastrointestinal/diagnóstico por imagem , Hamartoma/diagnóstico por imagem , Hemangioma/diagnóstico por imagem , Humanos , Hiperplasia/diagnóstico por imagem , Polipose Intestinal/diagnóstico por imagem , Leiomioma/diagnóstico por imagem , Lipoma/diagnóstico por imagem , Linfoma/diagnóstico por imagem , Imagem por Ressonância Magnética , Tumores Neuroendócrinos/diagnóstico por imagem , Pâncreas , Tomografia Computadorizada por Raios X , Tuberculose Gastrointestinal/diagnóstico por imagem
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