cystic dilatation of Brunner glands

Etiology

 Brunner gland hyperplasia

• Brunner glands consist of mucin-secreting glands that are normally located in the deep mucosa and submucosa of the duodenum.
• These glands protect the duodenal mucosa from the damaging effects of gastric acid.
• In addition, they xtend from the pylorus to the second portion of the duodenum, up to the papilla, and may, in rare cases, extend to the proximal jejunum.
• Histologically, Brunner’s gland hyperplasia may manifest as solitary or multiple small nodules composed of proliferating glands with maintenance of a lobular architecture and fibrous septa separating the hyperplastic lobules.
• They can show a cystic appearance because of the dilatation of the glandular acini or ducts.
• Brunner’s gland hyperplasia is clinically important because it can be mistaken for neoplastic lesions, although it is usually asymptomatic.
• A barium study indicates that Brunner’s gland hyperplasia commonly appears as smooth, polypoid lesions of the duodenum and may show markedly thickened, irregular folds in the proximal duodenum because of concomitant duodenitis.
• Moreover, Brunner’s gland hyperplasia may be detected on transabdominal US as a lesion with a heterogeneous echotexture because of multiple small cysts.
• Only a few reports have described the various CT findings of Brunner’s gland hyperplasia, including findings of a homogeneously-enhancing mass or of a heterogeneous and hypoattenuating mass with contrast administration.

References

 Cystic Lesions of the Gastrointestinal Tract : http://synapse.koreamed.org/Synapse/Data/PDFData/0068KJR/kjr-11-457.pdf