A CASE OF DUODENAL BRUNNER'S GLAND HAMARTOMA IN WHICH MAGNIFYING ENDOSCOPY WAS USEFUL FOR PREOPERATIVE DIAGNOSIS

DOI
  • OSUGA Takahiro
    Sapporo Medical University School of Medicine, Department of Medical Oncology and Hematology.
  • SATO Yasushi
    Sapporo Medical University School of Medicine, Department of Medical Oncology and Hematology.
  • ISHIKAWA Kazuma
    Sapporo Medical University School of Medicine, Department of Medical Oncology and Hematology.
  • ONUMA Hiroyuki
    Sapporo Medical University School of Medicine, Department of Medical Oncology and Hematology.
  • OKAGAWA Yutaka
    Sapporo Medical University School of Medicine, Department of Medical Oncology and Hematology.
  • SUGITA Shintarou
    Sapporo Medical University School of Medicine, Department of Surgical Pathology.
  • AKIYAMA Takehide
    Sapporo Kyouritsu Gorinbashi Hospital, Gastroenterological Center.
  • KOBUNE Masayoshi
    Sapporo Medical University School of Medicine, Department of Medical Oncology and Hematology.
  • TAKIMOTO Rishu
    Sapporo Medical University School of Medicine, Department of Medical Oncology and Hematology.
  • KATO Junji
    Sapporo Medical University School of Medicine, Department of Medical Oncology and Hematology.

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Other Title
  • 拡大内視鏡観察が術前診断に有用であった十二指腸Brunner腺過誤腫の1例

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Description

A 70-year-old man was referred to our hospital to treat a polyp in the duodenal bulb. Endoscopic examination showed that the polyp was composed of Yamada type IV lesions with thick stems and a head that was reddish. Magnifying endoscopy revealed a small opening and gastric epithelial metaplasia in the head of the polyp. We performed polypectomy for therapeutic diagnosis. Histologically, the lesion was a duodenal Brunner's gland hamartoma with abundant mature adipose tissue and gastric metaplasia. Brunner's gland hamartoma is composed of hyperplastic Brunner's glands mixed with elements such as adipose tissue, and is often accompanied by gastric epithelial metaplasia. Because diagnosis by biopsy is not possible, preoperative diagnosis of the disease is difficult. However, magnifying endoscopy enabled us to detect some characteristic findings of the disease, such as a small opening and gastric epithelial metaplasia. As a result, preoperative diagnosis might be possible by magnifying endoscopy. This case suggested that magnifying endoscopy is useful for the diagnosis of Brunner's gland hamartoma.

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