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Difference between revisions of "Duodenum"
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**Too much blue and epithelium in the wrong place. | **Too much blue and epithelium in the wrong place. | ||
====More==== | ====More==== | ||
*H. pylori only in areas of gastric metaplasia.<ref>El-Zimaity. 18 October 2010.</ref> | *[[Helicobacter duodenitis|H. pylori]] only in areas of [[Gastric heterotopia of the duodenum|gastric metaplasia]].<ref>El-Zimaity. 18 October 2010.</ref> | ||
===Duodenal nodules DDX=== | ===Duodenal nodules DDX=== | ||
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The epithelium matures appropriately. There is no increase in intraepithelial lymphocytes. No foveolar metaplasia of the epithelium is identified. | The epithelium matures appropriately. There is no increase in intraepithelial lymphocytes. No foveolar metaplasia of the epithelium is identified. | ||
==Helicobacter duodenitis== | |||
*Helicobacter is the most common cause of duodenitis.<ref>URL: [https://www.saintlukeskc.org/health-library/duodenitis https://www.saintlukeskc.org/health-library/duodenitis]. Accessed on: 2024 Feb 5.</ref><ref>URL: [https://www.webmd.com/digestive-disorders/what-is-duodenitis https://www.webmd.com/digestive-disorders/what-is-duodenitis]. Accessed on: 2024 Feb 5.</ref> | |||
*Overall, Helicobacter is rare in the duodenum. | |||
**Infection associated with [[Gastric heterotopia of the duodenum|gastric metaplasia]].<ref name=pmid7769188>{{cite journal |authors=Yang H, Dixon MF, Zuo J, Fong F, Zhou D, Corthésy I, Blum A |title=Helicobacter pylori infection and gastric metaplasia in the duodenum in China |journal=J Clin Gastroenterol |volume=20 |issue=2 |pages=110–2 |date=March 1995 |pmid=7769188 |doi=10.1097/00004836-199503000-00007 |url=}}</ref> | |||
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<pre> | |||
A. Duodenum, Biopsy: | |||
- Active duodenitis associated with foveolar epithelium and HELICOBACTER-LIKE ORGANISMS. | |||
- NEGATIVE for dysplasia. | |||
</pre> | |||
=Weird stuff= | =Weird stuff= | ||
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Image:Small_intestine_neuroendocrine_tumour_high_mag.jpg | Neuroendocrine tumour - high mag. (WC) | Image:Small_intestine_neuroendocrine_tumour_high_mag.jpg | Neuroendocrine tumour - high mag. (WC) | ||
</gallery> | </gallery> | ||
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<pre> | |||
Duodenum, Biopsy: | |||
- Incidental neuroendocrine tumour, grade 1, see comment. | |||
- Background small bowel mucosa with Brunner's glands within normal limits. | |||
Comment: | |||
The tumour stains as follows: | |||
POSITIVE: AE1/AE3, CD56, synaptophysin. | |||
NEGATIVE: S-100, CD68. | |||
PROLIFERATION (Ki-67): <2%. | |||
</pre> | |||
==Ampullary tumours== | ==Ampullary tumours== | ||
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*Commonly found in association foveolar metaplasia - especially in sporadic cases ~60% of cases. | *Commonly found in association foveolar metaplasia - especially in sporadic cases ~60% of cases. | ||
**In FAP ~30% of cases have foveolar metaplasia.<ref name=pmid16837629>{{Cite journal | last1 = Rubio | first1 = CA. | title = Gastric duodenal metaplasia in duodenal adenomas. | journal = J Clin Pathol | volume = 60 | issue = 6 | pages = 661-3 | month = Jun | year = 2007 | doi = 10.1136/jcp.2006.039388 | PMID = 16837629 | PMC = 1955048}}</ref> | **In FAP ~30% of cases have foveolar metaplasia.<ref name=pmid16837629>{{Cite journal | last1 = Rubio | first1 = CA. | title = Gastric duodenal metaplasia in duodenal adenomas. | journal = J Clin Pathol | volume = 60 | issue = 6 | pages = 661-3 | month = Jun | year = 2007 | doi = 10.1136/jcp.2006.039388 | PMID = 16837629 | PMC = 1955048}}</ref> | ||
*A colonscopy is recommended in individuals with nonampullary duodenal adenomas, as they are likely at increased risk of large bowel adenomas.<ref name=pmid26811631>{{Cite journal | last1 = Lim | first1 = CH. | last2 = Cho | first2 = YS. | title = Nonampullary duodenal adenoma: Current understanding of its diagnosis, pathogenesis, and clinical management. | journal = World J Gastroenterol | volume = 22 | issue = 2 | pages = 853-61 | month = Jan | year = 2016 | doi = 10.3748/wjg.v22.i2.853 | PMID = 26811631 }}</ref> | |||
===Sign out=== | ===Sign out=== | ||
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- TUBULAR ADENOMA. | - TUBULAR ADENOMA. | ||
-- NEGATIVE FOR HIGH-GRADE DYSPLASIA. | -- NEGATIVE FOR HIGH-GRADE DYSPLASIA. | ||
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====Alternate==== | |||
<pre> | |||
Polyp (Nonampullary), Duodenum, Polypectomy: | |||
- Tubular adenoma, NEGATIVE for high-grade dysplasia. | |||
Comment: | |||
A colonscopy is recommended if not done recently, as individual with nonampullary duodenal adenomas are likely at increased risk of large bowel adenomas.[1] | |||
1. Therap Adv Gastroenterol. 2012 Mar; 5(2): 127138. doi: 10.1177/1756283X11429590 | |||
</pre> | </pre> | ||