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duodenal anomalies

Monday 10 January 2005

duodenal lesions

Types

- duodenitis

  • chronic non-specific duodenitis (60.0%)

- duodenal ulcer (17,8%)
- duodenal heterotopic gastric mucosa (14.3%)
- duodenal hyperplastic polyp (2.8%)
- duodenal Brunner gland hyperplasia (2.5%)
- duodenal Brunner gland adenoma (1.4%)
- duodenal lymphoid polyp (0.8%)
- duodenal tubular adenoma (0.7%)
- duodenal lymphangioma (0.4%)
- duodenal endocrine cell micronests (0.2%)
- duodenal amyloidosis (0.2%).

Development

- chronic non-specific duodenitis (60.0%)

- duodenal ulcer (17,8%)

  • The duodenal ulcer is characterized by exudate, necrosis, granulation tissue and regenerative epithelium.
  • The regenerative epithelium infrequently mimicked adenocarcinoma .
  • Necrosis, exudates, infiltration of neutrophils and lymphocytes are recognized.

- duodenal heterotopic gastric mucosa (14.3%)

  • The hererotopic gastric mucosa is recognized as slight elevated or discolored lesion.
  • Heterotopic gastric mucosa consisted of two types: one is composed of only foveolar epithelium and another foveolar epithelium and fundic glands.
  • The foveolar epithelium occasionally shows hyperplastic changes.

- duodenal hyperplastic polyp (2.8%)

  • The hyperplastic polyp is composed of hyperplastic columnar epithelium with mucins.
  • It resembles to hyperplastic polyp of the stomach.
  • Hyperplasia of gastric foveolar-like cells is recognized.

- duodenal Brunner gland hyperplasia (2.5%)

  • The Brunner’s gland hyperplasia is recognized as an elevated or polyp lesion.
  • It is histologically characterized by hyperplastic proliferation of the gland. However, in biopsy specimens, differentiation from Brunner’s gland adenoma was occasionally difficult.

- duodenal Brunner gland adenoma (1.4%)

  • The Brunner gland adenoma is recognized as a polypoid elevation or polyp lesion.
  • It is histologically characterized by neoplastic proliferation of the gland.

- duodenal lymphoid polyp (0.8%)

  • The lymphoid polyp is recognized as a polyp.
  • It is histologically characterized by a large lymph follicle with a large germinal center.
  • The histology and imunohistochemical study demonstrated that it is different from follicular lymphoma and other types of lymphoma.
  • Hyperplastic lymph follicle is recognized.

- duodenal tubular adenoma (0.7%)

  • The tubular adenoma is recognized as flat or elevated lesions.
  • It is histologically characterized by adenomatous proliferation of intestinal epithelium , similar to colon adenoma.
  • Immunohistochemically, the tubular adenoma is negative for p53 protein, and Ki-67 labeling is low (mean Ki-67 labeling = 8%).
  • Adenomatous proliferation of intestinal epithelium is recognized.
  • The appearances are similar to colonic adenoma.

- duodenal lymphangioma (0.4%)

  • The lymphangioma is recognized as polyp or submucosal tumor.
  • It was characterized by submucosal cavernous proliferation of lymphatics free of red blood cells.
  • No atypia was recognized.
  • Numerous of lymphatics is recognized.

- duodenal endocrine cell micronests (0.2%)

  • The endocrine cell micronests are recognized as a flat discolored lesion.
  • It is pathologically characterized by non-neoplasmic proliferation of neuroendocrine cells positive for synaptophysin, neuro- specific enolase, and CD56.

- duodenal amyloidosis (0.2%).

  • It is recognized as a polyp.
  • Pathologically, it is characterized by deposition of amorphous materials positive with Congo-red stain.
  • Red amorphous substance is noted in the mucosa. The substance is positive with Congo-red stain.

References

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