Sporadic Nonampullary Duodenal Adenoma Overriding the Cystic Dilatation of Brunner's Gland Hyperplasia

Yun Jung Nam; Byung-Wook Kim; Joon Sung Kim; Gi Jun Kim

doi:10.4166/kjg.2017.70.3.141

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Nam, Kim, Kim, and Kim: Sporadic Nonampullary Duodenal Adenoma Overriding the Cystic Dilatation of Brunner's Gland Hyperplasia

Case Report

Korean J Gastroenterol 2017;70(3):141-144.

Published online: 4 October 2017

DOI: https://doi.org/10.4166/kjg.2017.70.3.141

Sporadic Nonampullary Duodenal Adenoma Overriding the Cystic Dilatation of Brunner's Gland Hyperplasia

Yun Jung Nam, Byung-Wook Kim, Joon Sung Kim, Gi Jun Kim

Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea

Correspondence to: Byung-Wook Kim, Division of Gastroenterology, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 56 Dongsu-ro, Bupyeong-gu, Incheon 21431, Korea. Tel: +82-32-280-5052, Fax: +82-32-280-5987, E-mail: gastro@catholic.ac.kr

Received 19 June 2017 Revised 8 August 2017 Accepted 22 August 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Sporadic non-ampullary duodenal adenoma is uncommon and found incidentally during endoscopic examinations. Brunner's gland hyperplasia is commonly encountered during endoscopic examinations. Adenomas arising from Brunner's gland hyperplasia origi-nate from the glandular cells, and the surface epithelia are usually intact. Little has been reported on adenomas originating from the surface epithelium that overrides Brunner's gland hyperplasia. Here, we report a case of a sporadic non-ampullary duodenal adenoma overriding the cystic dilatation of Brunner's gland hyperplasia.

Keywords: Brunner's gland hyperplasia, Adenoma, Endoscopic resection

References

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Fig. 1.

Duodenoscopy of the lesion. (A) A nodular lesion (black arrows) is overriding a cystic lesion (white arrows). (B) Narrow band image shows more discrete lesion with different pit patterns (white arrows) compared with background cystic lesions.

Fig. 2.

Endoscopic ultrasound of the lesion. A hypoechoic homogenous lesion is located at the submucosal layer (white arrows).

Fig. 3.

Endoscopic mucosal resection of the lesion. (A) The lesion is located at the second portion of the duodenum. (B) Snaring was performed. (C) The lesion was removed completely. (D) The lesion was measured as 1.5×1.2 cm.

Fig. 4.

Histopathology of the lesion (H&E stain, ×40). Adenoma is overriding the Brunner's gland and the two lesions are separated.

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