A case of duodenal pyloric gland adenoma with high-grade dysplasia arising from ectopic gastric mucosa

IF 1.4 Q4 GASTROENTEROLOGY & HEPATOLOGY

DEN open Pub Date : 2025-05-06 DOI:10.1002/deo2.70135

Kenichiro Nakachi, Hironobu Nagumo, Tetsuro Okura, Wataru Ohno, Takashi Ashikawa, Tomoyuki Funato, Toshiyasu Shiratori, So Nakaji, Shion Ando

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Abstract

Superficial non-ampullary duodenal epithelial tumor is a rare disease, but its frequency has reportedly been increasing in recent years. We report a case of duodenal pyloric gland adenoma with high-grade dysplasia arising from ectopic gastric mucosa. Esophagogastroduodenoscopy detected a 5-mm raised lesion on the anterior surface of the duodenal bulb. The lesion was diagnosed as gastric foveolar metaplasia with biopsy. A second esophagogastroduodenoscopy was performed 13 years later. The nodule showed a two-stage elevation and a biopsy revealed EGM. The lesion was followed up with EGD almost every year, with enlargement observed each time. Endoscopic submucosal dissection was performed. Histopathological examination revealed pyloric gland adenoma with high-grade dysplasia. Ectopic gastric mucosa was observed in the tumor pathologically and transformation of the EGM into a tumor was followed endoscopically over time.

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胃粘膜异位引起的十二指肠幽门腺腺瘤伴高度不典型增生1例

浅表性非壶腹性十二指肠上皮肿瘤是一种罕见的疾病，但近年来发病率有所上升。我们报告一例由胃粘膜异位引起的十二指肠幽门腺腺瘤伴高度不典型增生。食管胃十二指肠镜检查在十二指肠球前表面发现一个5毫米隆起的病变。经活检诊断为胃小泡化生。13年后进行第二次食管胃十二指肠镜检查。结节呈两期升高，活检显示EGM。几乎每年对病变进行EGD随访，每次均观察到肿大。内镜下粘膜夹层。组织病理学检查显示幽门腺腺瘤伴高度不典型增生。病理观察到异位的胃粘膜在肿瘤中，并随着时间的推移在内镜下观察到EGM向肿瘤的转变。

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来源期刊

DEN open

CiteScore

1.30

自引率

0.00%

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