Brunner’s Gland Hyperplasias and Hamartomas in Association with Helicobacter pylori

Abstract

Background. The proliferative lesions of the Brunner’s glands (BGs) are hyperplasia and hamartomas, and they are usually asymptomatic and very rarely diagnosed. The aetiology of these lesions is not yet clear. The aim of this study is to evaluate the clinical presentations of patients with BG hyperplasia and hamartomas and to assess the pathological features of these lesions in association with Helicobacter pylori (H. pylori). Methods. Our retrospective study included patients who underwent upper gastrointestinal system endoscopy between 2010 and 2015. The hospital records of 18 patients diagnosed with hyperplasia or hamartoma of BG were reviewed for the clinical and pathological findings. Data from patients with BG lesion were compared with 37 patients who had nonspecific duodenitis as the control group. Results. Female/male ratio in our study sample was 1/1. The age range was between 16 and 85 years with a mean age of 48.61. BG hyperplasia and hamartomas were found in 72.22 and 27.78% of the patients, respectively. The rate of H. pylori in gastric mucosa was 43.2% in the control group and 66.7% in the BG lesion group. In the BG lesion group, the rate of H. pylori was higher. H. pylori was identified in 60% of BG hamartomas and in 69.2% of hyperplastic BGs. Conclusion. Our study demonstrated that H. pylori may play an important role in the development of BG hyperplasia and hamartomas in association with chronic gastritis and duodenitis. This is probably due to chronic irritation.

Brunner’s glands hamartoma with pylorus obstruction: a case report and review of literature

“…Proliferative lesions of the BGs are uncommon small intestinal lesions, encountered primarily in the proximal duodenum and account for approximately 5–10% of all duodenal masses and less than 1% of all gastrointestinal tumors [ 4 ]. These lesions include hyperplasia/adenoma (nodule/polyp), hamartoma (BGH) and extremely rarely adenocarcinoma [ 3 ].…”

“…The etiology and pathogenesis of BG hyperplastic and hamartomatous lesions are not fully understood. The suggested causes are those associated with chronic local irritation, hyperchlorhydria, H. pylori infection, and pancreatic exocrine insufficiency [ 4 ]. Brunner’s gland proliferative lesions can present at any age, but commonly observed between the ages of 50 and 60 years and affect both sexes equally [ 6 ].…”

“…Proliferative lesions of the BGs include hyperplasia, adenoma (BGs nodule), hamartoma (BGH) and extremely rarely adenocarcinoma [ 3 ]. Benign proliferative lesions of the BG account for 5–10% of all benign duodenal masses and less than 1% of all gastrointestinal tumors [ 4 ]. These lesions are often identified incidentally during endoscopy, can be intraluminal or polypoid/exophytic, sessile or pedunculated and can be treated by endoscopic or surgical resection [ 5 ].…”

Brunner’s Gland Hamartoma of the Duodenum: A Literature Review

“…Another hypothesis is that Hp infection may contribute to the pathogenesis of Brunner's gland hamartoma. Three studies found that patients with Brunner's gland hyperplasia or hamartoma have a high positive Hp infection rate of 56.6-71.0% [21][22][23], but another study reported that none had Hp infection [10] (Table 1). Thus, it is necessary to further analyze the relationship of Hp infection with Brunner's gland hamartoma.…”

Review: Diagnosis ofHelicobacter pyloriinfection

“…Another study focused on pathology and also showed the role of H pylori on Brunner's gland hyperplasia and hamartomas in the duodenum 17 …”