Gastric heterotopia of the duodenum
(Redirected from Gastric heterotopia of duodenum)
Jump to navigation
Jump to search
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 of the duodenum, 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 caused by Helicobacter pylori.[2]
- Helicobacter duodenitis is associated with gastric metaplasia.[3]
Clinical DDx:[4]
- Duodenal polyp, duodenal ulcer, tumour/submucosal tumour, duodenal carcinoma, and duodenitis.
Classification
According to Terada it can be subdivided into:[4]
- 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.[5]
Microscopic
Features:
- Foveolar epithelium.
- Gastric glands - body-type or antral-type.
- Small bowel mucosa +/- Brunner's glands.
DDx:
- Foveolar metaplasia (isolated) - see peptic duodenitis.
- Foveolar gastric-type dysplasia.[6]
- Stomach with intestinal metaplasia.
Images
www:
Sign out
Duodenum, Biopsy: - Duodenal mucosa with gastric (body-type) heterotopia, otherwise within normal limits.
Block letters
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.
- ↑ Yang H, Dixon MF, Zuo J, Fong F, Zhou D, Corthésy I, Blum A (March 1995). "Helicobacter pylori infection and gastric metaplasia in the duodenum in China". J Clin Gastroenterol 20 (2): 110–2. doi:10.1097/00004836-199503000-00007. PMID 7769188.
- ↑ 4.0 4.1 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.