title: Brunner's gland adenoma with a focus of p53-positive atypical glands.
abstract: A submucosal tumor was resected endoscopically from the duodenal bulb in a 43-year-old man complaining of epigastric discomfort. The tumor, measuring 22 x 20 x 19mm, consisted mainly of Brunner's glands with no atypia. However, close histologic examination disclosed a focus of glands with cellular and structural atypia. The atypical glands showed staining by periodic acid-Schiff, alcian blue, and high iron-diamine methods. Mucin histochemistry was examined, and the atypical glands resembled the excretory ducts rather than the acinar cells of the tumor. Immunohistochemically, positivity for MIB-1 was high (38.0%), and p53-positive cells were detected sporadically in the atypical glands. These results indicated that the atypical glands probably represented a neoplastic lesion. Brunner's gland adenomas associated with foci of true neoplasm are very rare; only two cases, including one patient with microcarcinoid tumors, have been reported.
authors.affiliation: Fujimaki Clinic, Hanamaki, Japan.
authors.forename: E
authors.initials: E
authors.lastname: Fujimaki
authors.forename: S
authors.initials: S
authors.lastname: Nakamura
authors.forename: T
authors.initials: T
authors.lastname: Sugai
authors.forename: Y
authors.initials: Y
authors.lastname: Takeda
mesh_terms: D000236:Adenoma / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D000328:Adult; D034961:Antigens, Nuclear; D014408:Biomarkers, Tumor; D002011:Brunner Glands / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D004379:Duodenal Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D004384:Duodenoscopy; D006801:Humans; D019394:Ki-67 Antigen; D008297:Male; D009687:Nuclear Proteins / Q000378:metabolism; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism*
chemical_list: D034961:Antigens, Nuclear; D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D009687:Nuclear Proteins; D016159:Tumor Suppressor Protein p53