Brunner's gland hyperplasia and recurrent gastric impaction in a horse

Abstract

While Brunner's gland hyperplasia may rarely be considered as a cause of chronic gastric impaction in horses, it should be included in the differential diagnoses. A 7‐year‐old Cob cross‐breed gelding was presented with weight loss over a 3‐week period, and a diagnosis of chronic gastric impaction was made. Initial medical management was successful; however, the impaction recurred a further three times, at progressively shorter intervals, over the following 3 months. The owners subsequently elected euthanasia, and the horse was submitted for post‐mortem examination. A focal nodule within the cranial part of the duodenum was seen during the post‐mortem exam. Histopathologic evaluation of the duodenum revealed a marked increase in Brunner's glands admixed with distinct lobules of exocrine pancreatic tissue.

Brunner’s gland adenomas in two cats

“…These were arranged in small, occasionally slightly dilated, closely packed tubules containing scant basophilic material (Brunner’s glands [BGs]), which expanded the submucosa, elevated the mucosa, infiltrated the lamina propria and minimally compressed the adjacent major duodenal papilla (MDP) ( Figure 1 ). Anisocytosis and anisokaryosis were mild, and no mitotic figures were seen in 2.37 mm 2 . Small clusters of adipocytes, as well as follicular arrangements of lymphocytes and fewer plasma cells, were scattered within the polyp ( Figure 1 ).…”

“…BGs are tubuloacinar glands in the submucosa of the duodenum, responsible for secreting mucin, bicarbonate and alkaline substances to neutralize gastric acid and chyme as they enter the small intestine. 1 – 3 They are most concentrated in the proximal duodenum, decreasing in number throughout the length of the duodenum.…”

“…The literature on proliferative lesions of BGs in veterinary species is limited, with BG hyperplasia being reported in two horses, 2 , 8 sand rats ( Psammomys obesus ) 5 and transgenic mice. 9 BG adenoma has been reported in one dog and one of the horses with concurrent BG hyperplasia.…”

“…In the two cases reported in horses, BG hyperplasia has been characterized as a marked increase in BGs, which may create a gross nodule. 2 Such hyperplasia caused chronic gastric impaction in a 7-year-old Cob crossbreed gelding, which ultimately led to euthanasia. 2 Diffuse BG hyperplasia (coalescing nodules with a diameter up to 7 mm throughout the duodenum) and BG adenoma (a sessile mass with a diameter of approximately 2 cm) have been associated with recurrent gastric distension and colic in an Arabian mare.…”