Brunner Gland Hyperplasia / Hamartoma
Brunner Gland Adenoma
Epidemiology and Etiology:
- Incidental finding usually
- Association with:
- End-stage renal disease
- uremia
Common sites:
Gross features:
- Small polypoid excrescences (< 1cm typically)
- Nodular mucosal surface
Histologic features:
- Odze
approach:
- Endoscopically visible duodenal nodules with
lobules of Brunner glands within the mucosa in at least 50% of the
length of a biopsy specimen
- No distinction between hyperplasia / hamartoma
(it is an arbitrary size-based judgement so he just uses both)
- Brunners
glands normally are submucosal or extend into the lamina propria in the first part of the duodenum
- Note Brunner glands are histologically indistinguishable
from pyloric glands of the distal gastric mucosa
- Hyperplasia is also one of the changes of peptic
injury of the duodenum (peptic duodenitis) (Hx PUD):
- Villous shortening
- Gastric foveolar mucous cell metaplasia of the
villous epithelium
- Active inflammation within lamina propria or epithelium
- Hemorrhage and edema
Immunophenotype:
Marker:
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Sensitivity:
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Specificity:
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Molecular features:
Other features:
- No well-documented case of true glandular dysplasia
or carcinoma arising in proliferative Brunner glands have been reported
References:
- Odze
& Goldblum (eds.) Surgical
Pathology of the GI Tract, Liver, Biliary Tract, and Pancreas (3rd.
ed) (2015)