Cystic Brunner’s gland hamartoma in the duodenum: A case report

Park, Beom Jin; Kim, Min Ju; Lee, Ju Han; Sung, Deuk Jae; Cho, Sung Bum

doi:10.3748/wjg.15.4980

Cited by 16 publications

(8 citation statements)

References 10 publications

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“…4,5 In our case, cytological examination was able to exclude malignancy from the differential diagnosis. Given the suspicion of a pancreatic lesion raised initially by MSCT findings, a number of pancreatic lesions, such as intraductal papillary mucinous neoplasm (IPMN), primary or secondary clear-cell carcinoma or benign acinar pancreatic tissue, had to be considered in the differential diagnosis.…”

Section: Discussionmentioning

confidence: 85%

EUS–FNA of Brunner’s gland hamartoma: a case report

2011

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We describe endoscopic ultrasound, cytomorphological and immunocytochemical features of a large BrunnerÕs gland hamartoma (BGH). To the best of our knowledge, cytological findings of BGH have not yet been reported in detail, although Stewart et al. 1 reported a case in which endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) was performed. Case historyA 50-year-old woman was evaluated at an outside institution for iron deficiency anaemia. Esophagogastroduodenoscopy demonstrated a polypoid tumour in the distal duodenum. Punch biopsy was unremarkable. Multi-sliced computed tomography revealed a mass inseparable from the pancreatic head. Apart from anaemia (Hb 108 g ⁄ l), other laboratory findings were unremarkable. The patient was referred to our institution for EUS, which revealed a 40 · 63-mm mostly hypoechogenic mass with small cystic spaces, not in contact with the pancreatic head. The lesion was sited within the duodenal wall and probably originated in the fourth echolayer (Figure 1), so suspicion of gastrointestinal stromal tumour (GIST) was raised.Methods EUS-FNA was performed using a 22-gauge needle (Olympus EZ-Shot). A cytopathologist was present in the endoscopy room. Direct cytological smears were made and rapid on-site evaluation revealed uniform, benign looking cells, probably of epithelial origin. Two additional passes were made. All smears were airdried, and subsequently stained with May-Grü nwaldGiemsa (MGG) or stored for immunocytochemistry.

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Section: Discussionmentioning

confidence: 85%

EUS–FNA of Brunner’s gland hamartoma: a case report

2011

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“…Although rare, cystic Brunner gland hamartomas have also been reported (7,9,10). Brunner gland hamartomas are widely recognized as benign lesions; in a few cases, however, associated epithelial dysplasia or adenocarcinoma has been reported (1,7).…”

Section: Discussionmentioning

confidence: 95%

AIRP Best Cases in Radiologic-Pathologic Correlation: Brunner Gland Hamartoma

Houwers¹,

Bie²,

Hofstee³

2012

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A 68-year-old woman with a 2-month history of nausea and occasional vomiting was referred to the gastroenterologist. The patient complained of vague upper abdominal discomfort that was not influenced by meals. Laboratory findings were normal, and, specifically, no anemia was present (hemoglobin level, 8.4 mmol/L [normal, 7.1-9.9 mmol/L]; hematocrit level, 0.41 [normal, 0.34-0.48]). The patient reported normal bowel movements but mentioned a recent short period of diarrhea. Neither rectal bleeding nor melena was present, and fecal occult blood testing was not performed.A gastroscopy was performed by the gastroenterologist, who noted an extrinsic impression at the greater curvature of the stomach. The pyloric orifice was poorly recognized, and there was suspicion for an intussusception of part of the antrum into the duodenum. Rotation of the proximal part of the duodenum and reduction of the diameter of the duodenal lumen by more than 50% were present as the result of an external mass (Fig 1). The surface of the mass was mostly covered with normal-looking mucosa but became firm and ulcerative more distally. Because of the limited view at gastroscopy, it was difficult to determine whether the duodenal lumen reduction was the result of a submucosal mass or an external invading mass. Several biopsy specimens were obtained from both the normal-appearing mucosa proximal to the narrowed part of the duodenum and the more distal ulcerative surface.

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“…3 There are fourteen cases reported in the English literature. [1][2][3][4][5][6][7][8][9][10][11][12] Information from these cases and the current two is summarized in Table 1.…”

Section: Discussionmentioning

confidence: 99%