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Endocrine cell micronests (ECMs) are aggregates of endocrine cells known as enterochromaffin-like cells, typically measuring approximately 50 μm and usually observed in the mucosal layer of atrophic gastric fundic glands associated with hypergastrinemia. Although there are numerous reports on gastric ECMs, reports on duodenal ECMs are exceedingly rare. We report a rare case of Brunner's gland hyperplasia with increased endocrine cells and ECMs. An approximately 40 mm polyp was found in the duodenal bulb of a 57-year-old Japanese male patient during an upper gastrointestinal endoscopy, and a polypectomy was performed. Microscopic examination revealed hyperplasia of Brunner's glands in the duodenal polyp. Compared to normal Brunner's glands, hyperplastic Brunner's glands exhibited more endocrine cells. Additionally, many ECMs were observed in the fibromuscular connective tissue, comprising smooth muscle cells and myofibroblasts, adjacent to the hyperplastic Brunner's glands. The patient presented with hypergastrinemia (2,500 pg/mL; normal range: 30-140 pg/mL), and the ECMs were considered related to this condition. This case represents the first instance of a benign duodenal lesion with an increase in endocrine cells and the presence of ECMs., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. The Ethics Committee at the Affiliated Hospital of Hamamatsu University School of Medicine issued approval 81-004. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Meguro et al.)

Case Series Summary: Two cats, aged 13.5 and 14 years, presented with duodenal masses ultimately diagnosed as Brunner's gland (BG) adenomas. In the first cat, the lesion was a firm, pale tan, proximal duodenal polyp adjacent to the major duodenal papilla that was composed histologically of a well demarcated, expansile mass of well-differentiated BGs separated by fibrovascular septa and few adipocytes. This patient was euthanized for otitis-related vestibular signs, and the clinical significance of the duodenal polyp is unknown. The second cat presented with a 6-month history of vomiting. This cat had a mural duodenal mass in the region of the major duodenal papilla of approximately 2 cm, which was histologically composed of a dense population of variably ectatic BGs expanding the submucosa and lamina propria. This patient's mass was non-resectable, but the vomiting resolved after palliative gastroenterostomy loop surgery to allow ingesta to flow past the mass. The patient survived 35 months after the procedure., Relevance and Novel Information: BG adenoma is a rare, typically benign tumor in humans with non-specific clinical manifestations and no clear etiopathogenesis. This lesion, and the related condition BG hyperplasia, has been documented rarely in animals (one dog, two horses, and in mice and rats). This is the first description of the lesion in the cat. The comparative pathology, differential diagnoses and possible significance of these lesions are discussed., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Background: Duodenal Brunner's gland hyperplasia (BGH) is a therapeutic target when complications such as bleeding or gastrointestinal obstruction occur or when malignancy cannot be ruled out. Herein, we present a case of large BGH treated with endoscopic mucosal resection (EMR)., Case Summary: An 83-year-old woman presented at our hospital with dizziness. Blood tests revealed severe anemia, esophagogastroduodenoscopy showed a 6.5 cm lesion protruding from the anterior wall of the duodenal bulb, and biopsy revealed the presence of glandular epithelium. Endoscopic ultrasonography (EUS) demonstrated relatively high echogenicity with a cystic component. The muscularis propria was slightly elevated at the base of the lesion. EMR was performed without complications. The formalin-fixed lesion size was 6 cm × 3.5 cm × 3 cm, showing nodular proliferation of non-dysplastic Brunner's glands compartmentalized by fibrous septa, confirming the diagnosis of BGH. Reports of EMR or hot snare polypectomy are rare for duodenal BGH > 6 cm. In this case, the choice of EMR was made by obtaining information on the base of the lesion as well as on the internal characteristics through EUS., Conclusion: Large duodenal lesions with good endoscopic maneuverability and no evident muscular layer involvement on EUS may be resectable via EMR., Competing Interests: Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Brunner’s gland hamartoma is a submucosally localized and rarely encountered benign condition. Majority of cases are asymptomatic. Generally, it is diagnosed incidentally during endoscopic examinations of the upper gastrointestinal system (GIS) indicated for other reasons. It may sometimes present with symptoms of GIS bleeding or intestinal obstruction. In this paper, we present a 56-year-old female who was admitted to the emergency department with the complaints of nausea-vomiting and black-colored stool for two days. In upper GIS endoscopy, which was performed due to a pre-diagnosis of upper GIS bleeding, a submucosal mass was detected in the duodenum. The decision of surgery was taken for the patient who had an abdominal computed tomography demonstrating a duodenal mass. As a 4-cm polypoid mass was detected in duodenotomy performed after Kocher manoeuvre, mass excision was performed. The diagnosis of Brunner’s gland hamartoma was established based on the pathological analysis of the surgical specimen. The patient, who had no problem, but atelectasis in the postoperative follow-up, was discharged on the postoperative day seven.

Brunner's gland hamartomas (BGHs) are uncommon lesions of duodenum which show hyperplasia of these glands along with smooth muscle bundles, adipose tissue and lymphoid aggregates. These are usually benign, solitary, pedunculated, polypoidal lesions. Dysplastic changes in BGH are extremely rare and even rarer is the multiplicity of this lesion. We hereby report an index case of BGH showing features of high-grade dysplasia, presenting as multiple duodenal polyps.

Sporadic non-ampullary duodenal adenoma is uncommon and found incidentally during endoscopic examinations. Brunner’s gland hyperplasia is commonly encountered during endoscopic examinations. Adenomas arising from Brunner’s gland hyperplasia originate from the glandular cells, and the surface epithelia are usually intact. Little has been reported on adenomas originating from the surface epithelium that overrides Brunner’s gland hyperplasia. Here, we report a case of a sporadic non-ampullary duodenal adenoma overriding the cystic dilatation of Brunner’s gland hyperplasia.

Brunner’s gland hyperplasia is a rare cause of duodenal mass and gastrointestinal hemorrhage. Imaging and esophagoduodenoscopic evaluation of this condition are frequently consistent with a duodenal malignancy often resulting in surgical resection. However, the malignant potential of these lesions is still unknown, and most are benign. We report the case of a 74-year-old man who presented with fatal gastrointestinal bleeding and esophagoduodenoscopy findings consistent with a duodenal mass and mucosal ulceration. At autopsy, histologic examination of the mass revealed Brunner’s gland hyperplasia with associated ulcer formation. In this report, we review the findings associated with this case as well the literature regarding presentation, clinical associations, and treatment of Brunner’s gland hyperplasia.

Brunner’s gland adenoma is a rare benign tumor of small bowel, often incidentally discovered during endoscopy or radiological imaging. Mostly they are asymptomatic or often present with nonspecific symptoms such as nausea, vomiting, gastrointestinal hemorrhage, iron deficiency anemia. We reported a 76 years old male case presented with chief complaints of vomiting and black tarry stool. General physical examination was normal except mild tenderness over epigastrium. Esophagogastroduodenoscopy revealed a pedunculated polypoid tubular structure with blind end distally of length approximately 10-12* 3.5*1.5 cm in the second section of the duodenum with multiple skipped ulcers on the exposed surface of it. Additionally, there were few erosions in the duodenum proximally and multiple superficial ulcerations in the antrum, associated with helicobacter pylori confirmed by rapid urease test kit. Keywords: Brunner’s gland adenoma; Brunner’s gland hamartoma; Brunner’s gland hyperplasia; case report.

Objective: This study analyzes the epidemiological characteristics, etiological and pathogenic bases, clinical presentation, diagnosis and treatment of Brunner's gland hyperplasia. Methods: We describe a case of Brunner's gland hyperplasia that was diagnosed incidentally during elective endoscopy and review the available literature. Results: This neoplasm consists of glandular proliferation preferentially located in the proximal duodenum. Its diagnosis, normally made by endoscopic biopsy, can be associated with complications that, although infrequent, should not be underestimated. Conclusions: Duodenal neoplasms are a small percentage of those that affect the gastrointestinal tract. Because diagnosis is usually made by chance during a scheduled endoscopy, treatment should be based on the symptoms and size of the lesion according to the treatment standards of each medical center. [ABSTRACT FROM AUTHOR]

Brunner's gland hamartoma is a submucosally localized and rarely encountered benign condition. Majority of cases are asymptomatic. Generally, it is diagnosed incidentally during endoscopic examinations of the upper gastrointestinal system (GIS) indicated for other reasons. It may sometimes present with symptoms of GIS bleeding or intestinal obstruction. In this paper, we present a 56-year-old female who was admitted to the emergency department with the complaints of nausea-vomiting and black-colored stool for two days. In upper GIS endoscopy, which was performed due to a pre-diagnosis of upper GIS bleeding, a submucosal mass was detected in the duodenum. The decision of surgery was taken for the patient who had an abdominal computed tomography demonstrating a duodenal mass. As a 4-cm polypoid mass was detected in duodenotomy performed after Kocher manoeuvre, mass excision was performed. The diagnosis of Brunner's gland hamartoma was established based on the pathological analysis of the surgical specimen. The patient, who had no problem, but atelectasis in the postoperative follow-up, was discharged on the postoperative day seven. [ABSTRACT FROM AUTHOR]

Brunner’s glands are submucosal glands located in the proximal duodenum. Hyperplasia of the Brunner’s gland has been reported rarely in humans and animals. We examined sections of the Brunner’s gland from 63 sand rats submitted for necropsy over 2 years. Of the 63 animals necropsied, 45 (71%) had evidence of hyperplasia defined as nodular expansion, dilated ducts, or intraductal papillary proliferation. The hyperplasia was graded as mild in 22 (49%) of the cases, moderate in 15 (33%), and marked in 8 (18%). We found an association with both increased age and evidence of gastric ulceration and hyperplasia of the Brunner’s gland. In sand rats with marked hyperplasia, 8 of 8 (100%) had evidence of gastric ulceration, compared to 13 of 18 (72%) in animals with no hyperplasia. Animals with marked hyperplasia were, on average, 8.4 months older than animals with no hyperplasia. There was no association with gender. The lesion in sand rats is histologically similar to that in humans. [ABSTRACT FROM AUTHOR]

The combination of loss of habitat, human population encroachment, and increased demand of select nonhuman primates for biomedical research has significantly affected populations. There remains a need for knowledge and expertise in understanding background findings as related to the age, source, strain, and disease status of nonhuman primates. In particular, for safety/biomedical studies, a broader understanding and documentation of lesions would help clarify background from drug-related findings. A workshop and a minisymposium on spontaneous lesions and diseases in nonhuman primates were sponsored by the concurrent Annual Meetings of the American College of Veterinary Pathologists and the American Society for Veterinary Clinical Pathology held December 3–4, 2011, in Nashville, Tennessee. The first session had presentations from Drs Lowenstine and Montali, pathologists with extensive experience in wild and zoo populations of nonhuman primates, which was followed by presentations of 20 unique case reports of rare or newly observed spontaneous lesions in nonhuman primates (see online files for access to digital whole-slide images corresponding to each case report at http://www.scanscope.com/ACVP%20Slide%20Seminars/2011/Primate%20Pathology/view.apml). The minisymposium was composed of 5 nonhuman-primate researchers (Drs Bradley, Cline, Sasseville, Miller, Hutto) who concentrated on background and spontaneous lesions in nonhuman primates used in drug safety studies. Cynomolgus and rhesus macaques were emphasized, with some material presented on common marmosets. Congenital, acquired, inflammatory, and neoplastic changes were highlighed with a focus on clinical, macroscopic, and histopathologic findings that could confound the interpretation of drug safety studies. [ABSTRACT FROM PUBLISHER]

Brunner's gland hyperplasia (BGH) is an unusual entity that presents with large duodenal polyp or mass and rarely causes gastrointestinal bleeding. It is usually asymptomatic and often an incidental finding during the esophagoduodenoscopy (EGD). However, most of the cases are benign. We encounter a 40 years old man who presented in Emergency Room with melena. EGD revealed solitary, large duodenal polyp in second part of duodenum and later histopathological findings were consistent with BGH. [ABSTRACT FROM AUTHOR]

A case of duodenal neoplasm in the second portion of the duodenum is presented. Endoscopically, the lesion was characterized by a broad-based, submucosal tumor-like protrusion with a shallow central depression. The lesion was successfully removed by endoscopic mucosal resection. Histological examination of the resected specimen revealed the lesion to be composed of Brunner's gland hyperplasia in the submucosal layer and adenomatous glands in the mucosa. Our case suggests that neoplastic transformation possibly occurs in Brunner's gland hyperplasia. [ABSTRACT FROM AUTHOR]

A case of a patient with ectopic pancreas in the proximal jejunum associated with duodenal bile duct hamartoma and Brunner's gland hyperplasia is described. The simultaneous finding of these discrete and uncommon lesions has not been previously reported and allows for speculation about a common embryologic origin. [ABSTRACT FROM AUTHOR]

Brunner's gland adenoma (hyperplasia) (BGA/H) is a benign gastrointestinal lesion, usually asymptomatic and frequently detected incidentally by endoscopy as a submucosal nodule. Most BGA/Hs are diagnosed by their typical cytological morphology and immunohistochemical features, characterized by monomorphic cells arranged as loosely clusters of epithelial cells with abundant, clear, and granular cytoplasm, eccentrically located nuclei, and immunoreactivity for MUC-6. The combination of the clinical and pathological features is essential for rendering a correct diagnosis. Herein, we report two cases of BGA/H, including their cytologic and histologic features, and a literature review of the clinicopathologic findings along with its differential diagnoses., (© 2020 Wiley Periodicals LLC.)

Brunner's gland hyperplasia (BGH) of the duodenum is an uncommon finding at endoscopy and is usually asymptomatic. Symptomatic BGH presenting with biliary obstruction and pancreatitis is extremely rare and the literature is limited to a few case reports. We report an unusual case of diffuse BGH of duodenum involving the ampulla of Vater that led to this clinical presentation. Biopsies revealed BGH and successful endoscopic therapy utilizing sphincterotomy and plastic stent placement led to complete recovery. Albeit its uncommon clinical presentation, it can become challenging in terms of diagnosis and management. A high index of suspicion is of paramount importance for establishing the correct diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Brunner's gland hyperplasia is usually asymptomatic and found as an incidental finding after biopsy during upper gastrointestinal endoscopy. Symptomatic patients mostly present with either upper gastrointestinal bleed manifesting as melena or anemia, or with subacute intestinal obstruction manifesting as intractable nausea and vomiting. Gastric outlet obstruction secondary to Brunner's gland hyperplasia has been rarely reported. Conservative management with naso-gastric suction provides temporary improvement in symptoms. Most patients have near complete resolution of symptoms after resection of the culprit lesion. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

We report a case of Brunner's gland hyperplasia that was resected by an endoscopic polypectomy using a two-channel fiberscope and a detachable snare. A 59-year-old woman had tarry stool and anemia. Upper endoscopy revealed a large pedunculated polyp that arose from the anterior wall of the duodenal bulb. As we thought this polyp to be the source of bleeding, we performed an endoscopic removal. The lesion was removed by using a detachable snare without any complications. The resected specimen revealed a Brunner's gland hyperplasia. Endoscopic resection using the detachable snare was found to be a useful method for the prevention of the polypectomy-related bleeding in the treatment of Brunner's gland hyperplasia. [ABSTRACT FROM AUTHOR]