Difference between revisions of "Gastric heterotopia of the duodenum"
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{{ Infobox diagnosis | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | | Name = {{PAGENAME}} | ||
| Image = | | Image = Gastric heterotopia in the duodenum -- high mag.jpg | ||
| Width = | | Width = | ||
| Caption = | | Caption = Gastric heterotopia in the duodenum. [[H&E stain]]. | ||
| Synonyms = | | Synonyms = | ||
| Micro = | | Micro = foveolar epithelium, gastric glands (body-type or antral-type), small bowel mucosa +/-Brunner's glands | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = | | LMDDx = foveolar metaplasia (isolated) - see [[chronic duodenitis]], foveolar gastric-type dysplasia, [[intestinal metaplasia of the stomach]] | ||
| Stains = | | Stains = | ||
| IHC = | | IHC = | ||
| Line 13: | Line 13: | ||
| Molecular = | | Molecular = | ||
| IF = | | IF = | ||
| Gross = | | Gross = nodules/polyps | ||
| Grossing = | | Grossing = | ||
| Staging = | | Staging = | ||
| Line 55: | Line 55: | ||
#Foveolar epithelium. | #Foveolar epithelium. | ||
#Gastric glands - body-type or antral-type. | #Gastric glands - body-type or antral-type. | ||
*Small bowel mucosa +/- Brunner's glands. | |||
DDx: | DDx: | ||
*Foveolar metaplasia (isolated) - see [[chronic duodenitis]]. | *Foveolar metaplasia (isolated) - see [[chronic duodenitis]]. | ||
*Foveolar gastric-type dysplasia.<ref>{{Cite journal | last1 = Park | first1 = do Y. | last2 = Srivastava | first2 = A. | last3 = Kim | first3 = GH. | last4 = Mino-Kenudson | first4 = M. | last5 = Deshpande | first5 = V. | last6 = Zukerberg | first6 = LR. | last7 = Song | first7 = GA. | last8 = Lauwers | first8 = GY. | title = Adenomatous and foveolar gastric dysplasia: distinct patterns of mucin expression and background intestinal metaplasia. | journal = Am J Surg Pathol | volume = 32 | issue = 4 | pages = 524-33 | month = Apr | year = 2008 | doi = 10.1097/PAS.0b013e31815b890e | PMID = 18300795 }}</ref> | *Foveolar gastric-type dysplasia.<ref>{{Cite journal | last1 = Park | first1 = do Y. | last2 = Srivastava | first2 = A. | last3 = Kim | first3 = GH. | last4 = Mino-Kenudson | first4 = M. | last5 = Deshpande | first5 = V. | last6 = Zukerberg | first6 = LR. | last7 = Song | first7 = GA. | last8 = Lauwers | first8 = GY. | title = Adenomatous and foveolar gastric dysplasia: distinct patterns of mucin expression and background intestinal metaplasia. | journal = Am J Surg Pathol | volume = 32 | issue = 4 | pages = 524-33 | month = Apr | year = 2008 | doi = 10.1097/PAS.0b013e31815b890e | PMID = 18300795 }}</ref> | ||
*[[Stomach with intestinal metaplasia]]. | |||
===Images=== | ===Images=== | ||
Revision as of 12:43, 3 May 2016
| Gastric heterotopia of the duodenum | |
|---|---|
| Diagnosis in short | |
 Gastric heterotopia in the duodenum. H&E stain. | |
|
| |
| LM | foveolar epithelium, gastric glands (body-type or antral-type), small bowel mucosa +/-Brunner's glands |
| LM DDx | foveolar metaplasia (isolated) - see chronic duodenitis, foveolar gastric-type dysplasia, intestinal metaplasia of the stomach |
| Gross | nodules/polyps |
| Site | duodenum |
|
| |
| Prevalence | relatively common ~15% |
| Prognosis | benign |
| Clin. DDx | duodenal polyp, duodenal ulcer, tumour/submucosal tumour, duodenal carcinoma, duodenitis |
Gastric heterotopia of the duodenum is a relatively common finding of the duodenum.
General
- Common ~15% of cases in one series.[1]
- Probably not related to Helicobacter pylori.[2]
Clinical DDx:[3]
- Duodenal polyp, duodenal ulcer, tumour/submucosal tumour, duodenal carcinoma, and duodenitis.
Classification
According to Terada it can be subdivided into:[3]
- Foveolar epithelium with gastric pits
- Foveolar epithelium only.
Note:
- This article considers the former (foveolar epithelium with gastric pits) as gastric heterotopia. The later (foveolar epithelium only) is dealt with in the context of peptic duodenitis.
Gross
- Typically nodules/polyps.[4]
Microscopic
Features:
- Foveolar epithelium.
- Gastric glands - body-type or antral-type.
- Small bowel mucosa +/- Brunner's glands.
DDx:
- Foveolar metaplasia (isolated) - see chronic duodenitis.
- Foveolar gastric-type dysplasia.[5]
- Stomach with intestinal metaplasia.
Images
GH - low mag. (WC)
GH - intermed. mag. (WC)
GH - high mag. (WC)
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DUODENUM, BIOPSY: - SMALL BOWEL MUCOSA WITH GASTRIC (BODY-TYPE) HETEROTOPIA. - NEGATIVE FOR SIGNIFICANT PATHOLOGY.
Alternate
DUODENUM, BIOPSY: - SMALL BOWEL MUCOSA AND BRUNNER'S GLANDS WITHIN NORMAL LIMITS. - GASTRIC HETEROTOPIA, BODY-TYPE MUCOSA.
See also
References
- ↑ 1.0 1.1 Terada, T. (2012). "Pathologic observations of the duodenum in 615 consecutive duodenal specimens: I. benign lesions.". Int J Clin Exp Pathol 5 (1): 46-51. PMID 22295146.
- ↑ Genta, RM.; Kinsey, RS.; Singhal, A.; Suterwala, S. (Nov 2010). "Gastric foveolar metaplasia and gastric heterotopia in the duodenum: no evidence of an etiologic role for Helicobacter pylori.". Hum Pathol 41 (11): 1593-600. doi:10.1016/j.humpath.2010.04.010. PMID 20656325.
- ↑ 3.0 3.1 Terada, T. (Mar 2011). "Heterotopic gastric mucosa of the gastrointestinal tract: a histopathologic study of 158 cases.". Pathol Res Pract 207 (3): 148-50. doi:10.1016/j.prp.2010.12.004. PMID 21242038.
- ↑ Shousha, S.; Spiller, RC.; Parkins, RA. (Jan 1983). "The endoscopically abnormal duodenum in patients with dyspepsia: biopsy findings in 60 cases.". Histopathology 7 (1): 23-34. PMID 6840712.
- ↑ Park, do Y.; Srivastava, A.; Kim, GH.; Mino-Kenudson, M.; Deshpande, V.; Zukerberg, LR.; Song, GA.; Lauwers, GY. (Apr 2008). "Adenomatous and foveolar gastric dysplasia: distinct patterns of mucin expression and background intestinal metaplasia.". Am J Surg Pathol 32 (4): 524-33. doi:10.1097/PAS.0b013e31815b890e. PMID 18300795.