Inverted cystic tubulovillous adenoma involving Brunner's glands of duodenum.
Benign neoplasia of the duodenum are very rare. Moreover, duodenal tubulovillous adenomas are more uncommon lesions. The microscopic structure of tubulovillous adenoma has frond-like projection of mucosa with branching papillary structure and generally upward growth into the lumen. We describe a 72-year-old man who showed aduodenal tubulovillous adenoma with unusual inverted cystic growth pattern. Interestingly, this tubulovillous adenomatous lesion was interrupted by gastric metaplasia in the deep portion of the cyst and was closely surrounded by Brunner's glands. Although histogenesis of gastric metaplasia of duodenum is not fully understood, Brunner's glands has been suggested as a precursor for gastric metaplasia. Therefore, these findings argued that this adenoma arises from Brunner's glands through gastric metaplasia. This is the first case of inverted cystic tubulovillous adenoma involving Brunner's glands of duodenum with gastric metaplasia.
Kim
Ji Hoon
JH
Department of Internal Medicine, Guro Hospital, Korea University College of Medicine, 97, Guro-Dong Gil, Guro-Dong, Guro-Ku, Seoul, 152-703, South Korea.
Choi
Jung Woo
JW
Seo
Yeon Seok
YS
Lee
Beom Jae
BJ
Yeon
Jong Eun
JE
Kim
Jae Seon
JS
Byun
Kwan Soo
KS
Bak
Young-Tae
YT
Kim
Insun
I
Park
Jong-Jae
JJ
D000236:Adenoma / Q000473:pathology*; D000368:Aged; D002011:Brunner Glands / Q000473:pathology*; D003560:Cysts / Q000473:pathology*; D004379:Duodenal Neoplasms / Q000473:pathology*; D006801:Humans; D008297:Male