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Ortiz Requena D, Rojas C, Garcia-Buitrago M. Cytological diagnosis of Brunner's gland adenoma (hyperplasia): A diagnostic challenge. Diagn Cytopathol 2020; 49:E222-E225. [PMID: 33314802 DOI: 10.1002/dc.24680] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 11/17/2020] [Accepted: 11/23/2020] [Indexed: 12/19/2022]
Abstract
Brunner's gland adenoma (hyperplasia) (BGA/H) is a benign gastrointestinal lesion, usually asymptomatic and frequently detected incidentally by endoscopy as a submucosal nodule. Most BGA/Hs are diagnosed by their typical cytological morphology and immunohistochemical features, characterized by monomorphic cells arranged as loosely clusters of epithelial cells with abundant, clear, and granular cytoplasm, eccentrically located nuclei, and immunoreactivity for MUC-6. The combination of the clinical and pathological features is essential for rendering a correct diagnosis. Herein, we report two cases of BGA/H, including their cytologic and histologic features, and a literature review of the clinicopathologic findings along with its differential diagnoses.
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Affiliation(s)
- Domenika Ortiz Requena
- Department of Pathology and Laboratory Medicine, Jackson Memorial Hospital/University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Claudia Rojas
- Department of Pathology, Memorial Healthcare System/Joe DiMaggio Children Hospital, Miami, Florida, USA
| | - Monica Garcia-Buitrago
- Department of Pathology and Laboratory Medicine, Jackson Memorial Hospital/University of Miami Miller School of Medicine, Miami, Florida, USA
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Rath MM, Mohapatra D, Mohanty SK, Shantisudha S. Brunner's gland hamartoma with dysplasia, presenting as multiple duodenal polyps: An unexplored entity with literature review. INDIAN J PATHOL MICR 2019; 62:290-292. [PMID: 30971558 DOI: 10.4103/ijpm.ijpm_69_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
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.
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Affiliation(s)
- Mitali M Rath
- Department of Pathology, IMS and SUM Hospital, SOA University, Bhubaneswar, Odisha, India
| | - Debahuti Mohapatra
- Department of Pathology, IMS and SUM Hospital, SOA University, Bhubaneswar, Odisha, India
| | - Sandip K Mohanty
- Department of Pathology, IMS and SUM Hospital, SOA University, Bhubaneswar, Odisha, India
| | - Subhashree Shantisudha
- Department of Pathology, IMS and SUM Hospital, SOA University, Bhubaneswar, Odisha, India
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Satoh T, Matsubayashi H, Takizawa K, Ishiwatari H, Kakushima N, Fujie S, Yoshida M, Kawata N, Sasaki K, Terashima M, Ono H. Giant Brunner's Gland Hyperplasia of the Duodenum Diagnosed by Endoscopic Ultrasonography-guided Fine Needle Biopsy and Treated by Laparoscopic Endoscopic Cooperative Surgery. Intern Med 2019; 58:2009-2013. [PMID: 30918195 PMCID: PMC6702001 DOI: 10.2169/internalmedicine.2477-18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
A 57-year-old female was referred to our department for treatment of a duodenal submucosal tumor (SMT), which had been growing over the last five years. Computed tomography demonstrated a marginally enhanced mass, measuring 36 mm in diameter, containing internal multiple hypovascular areas. Endoscopic ultrasonography-guided fine needle biopsy was performed using a 20-gauge core trap needle, and the specimens showed benign Brunner's glands. She underwent laparoscopic endoscopic cooperative surgery and the SMT was completely removed without any adverse events. Histology of the resected tumor showed Brunner's gland hyperplasia (BGH). BGH is generally a benign lesion. However, an accurate diagnosis is required to avoid overtreatment when it mimics malignancy.
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Affiliation(s)
| | | | | | | | | | - Shinya Fujie
- Division of Endoscopy, Shizuoka Cancer Center, Japan
| | - Masao Yoshida
- Division of Endoscopy, Shizuoka Cancer Center, Japan
| | - Noboru Kawata
- Division of Endoscopy, Shizuoka Cancer Center, Japan
| | - Keiko Sasaki
- Division of Pathology, Shizuoka Cancer Center, Japan
| | | | - Hiroyuki Ono
- Division of Endoscopy, Shizuoka Cancer Center, Japan
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Nam YJ, Kim BW, Kim JS, Kim GJ. Sporadic Non-ampullary Duodenal Adenoma Overriding the Cystic Dilatation of Brunner's Gland Hyperplasia. Korean J Gastroenterol 2017; 70:141-144. [PMID: 28934830 DOI: 10.4166/kjg.2017.70.3.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
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.
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Affiliation(s)
- Yun Jung Nam
- Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Byung Wook Kim
- Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Joon Sung Kim
- Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Gi Jun Kim
- Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
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Meltser E, Federici M, Cooper R, Capanescu C, Behling KC. Fatal Gastrointestinal Hemorrhage in a Patient with Brunner's Gland Hyperplasia. Case Rep Gastroenterol 2017; 11:411-415. [PMID: 28878614 PMCID: PMC5567001 DOI: 10.1159/000477717] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 05/17/2017] [Indexed: 01/09/2023] Open
Abstract
Brunner's gland hyperplasia is a rare cause of duodenal mass and gastrointestinal hemorrhage. Imaging and esophagoduodenoscopic evaluation of this condition are frequently consistent with a duodenal malignancy often resulting in surgical resection. However, the malignant potential of these lesions is still unknown, and most are benign. We report the case of a 74-year-old man who presented with fatal gastrointestinal bleeding and esophagoduodenoscopy findings consistent with a duodenal mass and mucosal ulceration. At autopsy, histologic examination of the mass revealed Brunner's gland hyperplasia with associated ulcer formation. In this report, we review the findings associated with this case as well the literature regarding presentation, clinical associations, and treatment of Brunner's gland hyperplasia.
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Affiliation(s)
- Edward Meltser
- Department of Pathology and Laboratory Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
| | - Matthew Federici
- Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Robert Cooper
- Department of Gastroenterology, Cooper University Hospital, Camden, New Jersey, USA
| | - Cristina Capanescu
- Department of Gastroenterology, Cooper University Hospital, Camden, New Jersey, USA
| | - Kathryn C Behling
- Department of Biomedical Sciences, Cooper Medical School of Rowan University, Camden, New Jersey, USA.,Department of Pathology, Cooper University Hospital, Camden, New Jersey, USA
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Affiliation(s)
- Lucy Henderson
- Department of Paediatric Surgery, Leicester Royal Infirmary, Leicester, UK
| | - Cathy Richards
- Department of Histopathology, Leicester Royal Infirmary, Leicester, UK
| | - Anne Willmott
- Department of Paediatric Gastroenterology, Leicester Royal Infirmary, Leicester, UK
| | - Haitham Dagash
- Department of Paediatric Surgery, Leicester Royal Infirmary, Leicester, UK
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