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• W4296782402 abstract "HomeRadiologyVol. 306, No. 1 PreviousNext Reviews and CommentaryFree AccessImages in RadiologyDuodenal Brunner Gland HamartomaLindsey M. Negrete , Komal ChughtaiLindsey M. Negrete , Komal ChughtaiAuthor AffiliationsFrom the Department of Radiology, Stanford University School of Medicine, 453 Quarry Rd, Mail Code 5659, Stanford, CA 94305-6104.Address correspondence to L.M.N. (email: [email protected]).Lindsey M. Negrete Komal ChughtaiPublished Online:Sep 20 2022https://doi.org/10.1148/radiol.220539MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In Online supplemental material is available for this article.A 63-year-old woman was admitted for multiple episodes of hematemesis and melena. Hemoglobin on arrival was 7.2 g/dL (reference range, 11.7–15.7 g/dL), for which the patient was given two units of packed red blood cells. CT scan of the abdomen showed an endoluminal mass arising in the region of the gastric pylorus and the first portion of the duodenum, with a fat plane between the mass and the gastroduodenal artery and pancreas (Figure, Movie [online]). At endoscopy, a large subepithelial mass with cystic components was found at the duodenal bulb associated with gastric outlet obstruction. The patient underwent a distal gastrectomy and proximal duodenectomy with gastrojejunostomy. At pathologic examination, numerous Brunner glands without atypia or necrosis were found, which confirmed the diagnosis of a Brunner gland hamartoma (Fig E1 [online]).A 63-year-old woman presented with hematemesis and melena. CT scan of the abdomen with contrast shows a mass on the duodenal wall (orange arrow), medial displacement of the gastroduodenal artery (thin white arrow), and an intact fat plane between the mass and the pancreatic head (thick white arrow).Download as PowerPointOpen in Image Viewer Get the Flash Player to see this video.Movie: A 63 year-old female presented with hematemesis and melena. Axial cine movie (avi.file) of the abdominal CT showing the mass in the duodenum and the mass effect on the pancreas.Download Original Video (7.4 MB)The Brunner glands of the duodenal mucosa produce an alkaline solution and enterogastrone (an inhibitor of gastric acid secretion). These two actions are thought to play an important role in limiting peptic ulcer formation between the pylorus and ampulla of Vater. The size of these rare tumors determines their nomenclature. Lesions smaller than 5 mm represent hyperplasia, whereas lesions larger than 5 mm are called adenomas, Brunner gland hamartomas, or even Brunneromas (1,2). The etiology of Brunner gland hamartomas is unclear, although hyperacidity or Helicobacter pylori may provoke proliferation of these glands. The differential diagnosis of this duodenal mass includes leiomyoma, lipoma, lymphoma, carcinoid tumor, and adenocarcinoma.Disclosures of conflicts of interest: L.M.N. No relevant relationships. K.C. No relevant relationships.References1. 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(3):715–722. Crossref, Medline, Google Scholar2. Patankar AM, Wadhwa AM, Bajaj A, Ingule A, Wagle P. Brunneroma: A Rare Cause of Duodeno-duodenal Intussusception. Euroasian J Hepatogastroenterol 2016;6(1):84–88. Crossref, Medline, Google ScholarArticle HistoryReceived: Mar 14 2022Revision requested: Apr 11 2022Revision received: Apr 16 2022Accepted: Apr 25 2022Published online: Sept 20 2022Published in print: Jan 2023 FiguresReferencesRelatedDetailsRecommended Articles Fluoroscopic Evaluation of Duodenal DiseasesRadioGraphics2022Volume: 42Issue: 2pp. 397-416Pancreaticoduodenal Groove: Spectrum of Disease and Imaging FeaturesRadioGraphics2022Volume: 42Issue: 4pp. 1062-1080Case 248: Cystic Duodenal Dystrophy with Groove PancreatitisRadiology2017Volume: 285Issue: 3pp. 1045-1051Imaging Spectrum of Duodenal EmergenciesRadioGraphics2020Volume: 40Issue: 5pp. 1441-1457Heterotopic Pancreas: Histopathologic Features, Imaging Findings, and ComplicationsRadioGraphics2017Volume: 37Issue: 2pp. 484-499See More RSNA Education Exhibits Imaging Of Acute Gastric ConditionsDigital Posters2020Between the Duodenum and the Pancreas - What do We Know about Groove Pancreatitis?Digital Posters2019Imaging Characteristics of Hamartomas from Head to Toe and Their Differentials Digital Posters2019 RSNA Case Collection Bouveret SyndromeRSNA Case Collection2022Bouveret syndromeRSNA Case Collection2021Groove PancreatitisRSNA Case Collection2021 Vol. 306, No. 1 Supplemental MaterialMetrics Altmetric Score PDF download" @default.
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• W4296782402 title "Duodenal Brunner Gland Hamartoma" @default.
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• W4296782402 doi "https://doi.org/10.1148/radiol.220539" @default.
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