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Difference between revisions of "Duodenum"
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→Chronic duodenitis: split into two -- chronic duodenitis and 'peptic duodenitis'
(→Chronic duodenitis: split into two -- chronic duodenitis and 'peptic duodenitis') |
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==Chronic duodenitis== | ==Chronic duodenitis== | ||
===General=== | ===General=== | ||
* | *This is not very well defined as [[plasma cell]]s are present in a normal duodenum. | ||
* | |||
===Gross=== | |||
*Duodenal erythema. | |||
===Microscopic=== | |||
Features: | |||
*"Abundant" lamina propria plasma cells. | |||
*Villous blunting. | |||
*[[Brunner's gland hyperplasia]]. | |||
DDx: | |||
*[[Normal duodenum]]. | |||
===Sign out=== | |||
<pre> | |||
DUODENUM, BIOPSY: | |||
- MODERATE NON-SPECIFIC CHRONIC DUODENTIS (SMALL BOWEL MUCOSA WITH VILLOUS | |||
BLUNTING, PROMINENT BRUNNER'S GLANDS, ABUNDANT LAMINA PROPRIA PLASMA CELLS | |||
AND OCCASIONAL INTRAEPITHELIAL LYMPHOCYTES, WITHOUT FOVEOLAR METAPLASIA). | |||
- NEGATIVE FOR DYSPLASIA. | |||
</pre> | |||
==Peptic duodenitis== | |||
===General=== | |||
*A type of chronic duodenitis - considered to be a consequence of [[peptic ulcer disease]] ([[Helicobacter gastritis]]). | |||
*One of the key components of the diagnosis is foveolar metaplasia and it is disputed that this is really due to Helicobacter. | |||
**Genta ''et al.'' consider gastric foveolar metaplasia a congenital lesion.<ref name=pmid20656325>{{Cite journal | last1 = Genta | first1 = RM. | last2 = Kinsey | first2 = RS. | last3 = Singhal | first3 = A. | last4 = Suterwala | first4 = S. | title = Gastric foveolar metaplasia and gastric heterotopia in the duodenum: no evidence of an etiologic role for Helicobacter pylori. | journal = Hum Pathol | volume = 41 | issue = 11 | pages = 1593-600 | month = Nov | year = 2010 | doi = 10.1016/j.humpath.2010.04.010 | PMID = 20656325 }}</ref> | |||
===Microscopic=== | ===Microscopic=== | ||
| Line 216: | Line 241: | ||
*Gastric foveolar metaplasia - '''key feature'''. | *Gastric foveolar metaplasia - '''key feature'''. | ||
*[[Brunner's gland hyperplasia]]. | *[[Brunner's gland hyperplasia]]. | ||
*+/-Inflammation - neutrophils. | *+/-Inflammation - neutrophils.{{fact}} | ||
*Ulceration. | *Ulceration.{{fact}} | ||
DDx: | DDx: | ||
*[[Chronic duodenitis]] not otherwise specified - no foveolar metaplasia, abundant plasma cells. | |||
*[[Acute duodenitis]]. | *[[Acute duodenitis]]. | ||
*[[Brunner's gland hyperplasia]]. | *[[Brunner's gland hyperplasia]]. | ||
Images | ====Images==== | ||
<gallery> | |||
Image:Duodenum_with_foveolar_metaplasia_-_low_mag.jpg | Duodenum with foveolar metaplasia - low mag. (WC/Nephron) | |||
Image:Duodenum_with_foveolar_metaplasia_-_intermed_mag.jpg | Duodenum with foveolar metaplasia - intermed. mag. (WC/Nephron) | |||
Image:Duodenum_with_foveolar_metaplasia_-_alt_-_very_high_mag.jpg | Duodenum with foveolar metaplasia - very high mag. (WC/Nephron) | |||
</gallery> | |||
===Stains=== | ===Stains=== | ||
Foveolar metaplasia: | Foveolar metaplasia: | ||