The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지
DOI QR코드

DOI QR Code

A Case of Brunner's Gland Hyperplasia with Dysplasia

형성이상을 동반한 Brunner 샘 과다형성 1예

  • Kim, Min-Seong (Department of Internal Medicine, Good Gang-An Hospital) ;
  • Park, Jung-Min (Department of Internal Medicine, Good Gang-An Hospital) ;
  • Lee, Chang-Seog (Department of Internal Medicine, Good Gang-An Hospital) ;
  • Kim, Chul-Young (Department of Internal Medicine, Good Gang-An Hospital) ;
  • Lim, Young-Bae (Department of Internal Medicine, Good Gang-An Hospital) ;
  • Lee, Yong-Gyu (Department of Internal Medicine, Good Gang-An Hospital) ;
  • Lee, Dong-Hyun (Department of Internal Medicine, Good Gang-An Hospital)
  • Published : 2012.03.01
⟨ Previous Next ⟩

Abstract

Brunner's gland hyperplasia, also known as Brunner's gland adenoma, polypoid hamartoma, or Brunneroma, is a rare proliferative lesion arising from the Brunner's glands of the duodenum. These lesions have been described previously as benign, with no malignant potential. We report a case of Brunner's gland hyperplasia in the duodenum that was discovered incidentally during the endoscopic evaluation of anal bleeding. Histopathological examination of this Brunner's gland hyperplasia revealed well-marked, low-grade dysplasia. This case suggests a dysplastic stage with malignant potential in the natural history of Brunner's gland hyperplasia.

Brunner 샘 과다형성은 대부분 샘종이나 과오종과 같은 형태로서 십이지장의 양성 종양으로 알려져 왔다. 이 질환과 관련된 생명을 위협하는 합병증에 대한 사례는 종종 보고되었으나, 형성이상과 같은 악성 가능성을 보이는 사례는 드물었다. 저자들은 항문 출혈로 위장관 출혈에 대한 검사를 위해 시행한 상부위장관 내시경 검사에서 우연히 십이지장의 용종이 진단되었으며, 내시경 절제 후 조직 검사에서 악성화 가능성이 있는 형성이상을 동반한 Brunner 샘 과다형성이 발견된 경험이 있어 문헌고찰과 함께 보고한다.

Keywords

References

  1. Kim SM, Cho MA, Kim SH, et al. A case of a large pedunculated Brunner's gland adenoma treated by endoscopic polypectomy using metal clip. Korean J Med 2004;67:194-198.
  2. Lee KI, Han SG, Heo JH, et al. A case of Peutz-Jeghers syndrome with duodenal adenocarcinoma and obstruction. Korean J Med 1999;56:378-382.
  3. Kim KH, Lee OJ, Jung KM, Jang JE, Shim DS. Brunner's gland harmartoma causing gastric outlet obstruction treated by endoscopic resection. Korean J Med 1998;54:114-117.
  4. Sakurai T, Sakashita H, Honjo G, Kasyu I, Manabe T. Gastric foveolar metaplasia with dysplastic changes in Brunner gland hyperplasia possible precursor lesions for Brunner gland adenocarcinoma. Am J Surg Pathol 2005; 29:1442-1448. https://doi.org/10.1097/01.pas.0000180449.15827.88
  5. Doi K, Tada S, Fujimoto T, et al. Successful endoscopic removal of a duodenal adenoma occurring in Brunner's gland hyperplasia. Dig Endosc 2004;16:148-151 https://doi.org/10.1111/j.1443-1661.2003.00327.x
  6. Brookes MJ, Manjunatha S, Allen CA, Cox M. Malignant potential in a Brunner's gland hamartoma. Postgrad Med J 2003;79:416-417. https://doi.org/10.1136/pmj.79.933.416
  7. Ohta Y, Saitoh K, Akai T, Uesato M, Ochiai T, Matsubara H. Early primary duodenal carcinoma arising from Brunner's glands synchronously occurring with sigmoid colon carcinoma: report of a case. Surg Today 2008;38:756-760. https://doi.org/10.1007/s00595-007-3707-1
  8. Suda K, Hamada S, Takahashi M, et al. A true Brunner's gland adenoma. Endoscopy 2007;39(Suppl 1):E37-E38.
  9. Gao YP, Zhu JS, Zheng WJ. Brunner's gland adenoma of duodenum: a case report and literature review. World J Gastroenterol 2004;10:2616-2617.
  10. Lee SY, Lee JH, Jung HJ, et al. A case of giant Brunner's gland hamartoma presenting as gastrointestinal hemorrhage. Korean J Gastrointest Endosc 2007;34:47-50.
  11. Maeng CH, Jang JY, Joo KR, et al. A case of multiple cystic Brunner's gland hyperplasia. Korean J Gastrointest Endosc 2006;32:283-286.
  12. Park BJ, Kim MJ, Lee JH, Park SS, Sung DJ, Cho SB. Cystic Brunner's gland hamartoma in the duodenum: a case report. World J Gastroenterol 2009;15:4980-4983. https://doi.org/10.3748/wjg.15.4980
  13. Patel ND, Levy AD, Mehrotra AK, Sobin LH. Brunner's gland hyperplasia and hamartoma: imaging features with clinicopathologic correlation. AJR Am J Roentgenol 2006;187:715-722. https://doi.org/10.2214/AJR.05.0564
  14. Babich JP, Klein J, Friedel DM. Endoscopic removal of a brunneroma with EUS guidance. South Med J 2010;103: 250-252. https://doi.org/10.1097/SMJ.0b013e3181c95727
  15. Rocco A, Borriello P, Compare D, et al. Large Brunner's gland adenoma: case report and literature review. World J Gastroenterol 2006;12:1966-1968.
  16. Stewart ZA, Hruban RH, Fishman EF, Wolfgang CL. Surgical management of giant Brunner's gland hamartoma: case report and literature review. World J Surg Oncol 2009;7:68. https://doi.org/10.1186/1477-7819-7-68
  17. Block KP, Frick TJ, Warner TF. Gastrointestinal bleeding from a Brunner's gland hamartoma: characterization by endoscopy, computed tomography, and endoscopic ultrasound. Am J Gastroenterol 2000;95:1581-1583. https://doi.org/10.1111/j.1572-0241.2000.02124.x
  18. Krishnamurthy P, Junaid O, Moezzi J, Ali SA, Gopalswamy N. Gastric outlet obstruction caused by Brunner's gland hyperplasia: case report and review of literature. Gastrointest Endosc 2006;64:464-467. https://doi.org/10.1016/j.gie.2006.02.026

Cited by

  1. A Case Of Huge Brunner's Gland Adenoma With Acute Bleeding Treated By Endoscopic Resection vol.30, pp.2, 2015, https://doi.org/10.7180/kmj.2015.30.2.171