Obstructing hamartoma of Brunner's glands of the duodenum

Strutynsky, N; Posniak, Robert; Mori, Ken

doi:10.1007/bf01296929

Cited by 22 publications

(7 citation statements)

References 11 publications

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“…It is considered to originate in proper duodenal mucosa and is also found in patients suffering from familial adenomatosis coli. Most Brunner's gland tumours are probably not true neoplasms but rather hyperplasia or hamartomas [21], although some glands are cystically dilated and some may show dysplastic changes [27]. Brunner's gland tumour is composed of lobules of mature Brunner's glands surrounded by bands of smooth muscle originating from the muscularis mucosae, and the tumour is covered by normal duodenal mucosa [16].…”

Section: Discussionmentioning

confidence: 99%

’Pyloric gland-type adenoma' arising in heterotopic gastric mucosa of the duodenum, with dysplastic progression of the gastric type

Kushima¹,

Rüthlein²,

Stolte

et al. 1999

Virchows Archiv

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'Pyloric gland-type adenoma' is a recently described and very rare entity. We report a case of a pedunculated polyp of the duodenal bulb showing the features of pyloric gland-type adenoma. Heterotopic gastric mucosa was found adjacent to the tumour. Immunohistochemically, the tumour cells at the surface of the polyp showed foveolar-type mucin (M1) while most other tumour cells showed deep gastric mucin (M2), displaying a pattern of differentiation similar to the normal gastric mucosa. The polyp also showed villous or papillary structures with disorganization of gastric differentiation and marked increase of proliferating in foci cells. This is the first case of pyloric gland-type adenoma found to arise in heterotopic gastric mucosa of the duodenum, showing dysplastic progression of the gastric type.

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Section: Discussionmentioning

confidence: 99%

’Pyloric gland-type adenoma' arising in heterotopic gastric mucosa of the duodenum, with dysplastic progression of the gastric type

Kushima¹,

Rüthlein²,

Stolte

et al. 1999

Virchows Archiv

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“…Adenocarcinomas very rarely arise in Brunner's glands [4,5,8,9,16,22,23,29], gastric metaplasia, or heterotopic gastric mucosa [3,13,19,21]. Most Brunner's gland tumors, so-called Brunner's gland adenomas or brunneriomas, are not true neoplasms but rather hyperplasia or hamartomas, which are composed of lobules of mature Brunner's glands surrounded by bands of smooth muscle [18,24,29]. There have been only five well documented cases of carcinoma with neoplastic transformation of the underlying Brunner's glands [5,8,9,16,29].…”

Section: Introductionmentioning

confidence: 99%

Gastric-type adenocarcinoma of the duodenal second portion histogenetically associated with hyperplasia and gastric-foveolar metaplasia of Brunner's glands

et al. 2002

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We report a case of a pedunculated polyp with a focus of gastric-type adenocarcinoma arising in the opposite side of the papilla Vater of the duodenal second portion. The carcinoma was surrounded by lobules of hyperplastic Brunner's glands. Immunohistochemically the carcinoma tissue showed both gastric foveolar-type mucin ( MUC5AC) and pyloric/Brunner's gland-type mucin ( MUC6), in which proliferating cells positive for MIB-1 (Ki-67) were scattered diffusely. Most of the hyperplastic Brunner's glands were positive for MUC6, while cells toward the lumen in the superficial layer were positive for MUC5AC and MIB-1. This directional pattern of differentiation of Brunner's glands has recently been demonstrated by our group in the histogenetic course of gastric metaplasia originating directly from Brunner's glands. Therefore the present carcinoma is thought to have developed under induction of gastric-foveolar differentiation in a manner very similar to that of gastric metaplasia in hyperplastic Brunner's glands.

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“…However, specific problems have been described, such as obstruction (17)(18)(19), bleeding (20), perforation (21), biliary fistula (22), and heterotopic pancreatitis with resulting pseudocyst (23), and gastric duplication (24,25). Most individuals affected are middle-aged adults, and there is no obvious gender predilection (9).…”

Section: Discussionmentioning

confidence: 99%