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.
Adenoma ; Brunner Glands ; Duodenum ; Hamartoma ; Hemorrhage ; Hyperplasia ; Natural History

We report a case of adenocarcinoma originating from the duodenal Brunner glands in a 47-year-old female patient. The lesion was 0.8 cm in extent and located at the posterior wall of the first part of the duodenum. Histologically, the tumor showed transition from non-neoplastic Brunner glands through dysplastic epithelium into adenocarcinoma. The carcinoma cells were strongly positive for MUC6 protein, which is an epithelial marker for the Brunner glands. Tumor protein p53 was overexpressed in the carcinoma cells, but not in the non-neoplastic or dysplastic epithelium. Dystrophic calcification was predominant. This is the first case report of duodenal adenocarcinoma of Brunner gland origin in Korea.
Adenocarcinoma ; Brunner Glands ; Duodenum ; Epithelium ; Female ; Humans ; Korea ; Middle Aged

Brunner's gland hamartomas are rare tumors of duodenum, they are often discovered incidentally during esophagogastroduodenoscopy or upper gastrointestinal series. These tumors arise mainly in the duodenal bulb and can present with gastrointestinal hemorrhage and intestinal obstruction. Most of Brunner's gland hamartomas are located within the range of the standard esophagogastroduodenoscope. However, they are rarely located below the third portion of duodenum. As well known, the small intestine, including the 4th portion of duodenum, jejunum, and ileum, is relatively inaccessible with routine endoscopy. Thus, the diagnosis of Brunner's gland hamartoma in these area can be delayed up to several months after onset of symptoms. We report a case of Brunner's gland hamartoma which was located in the fourth portion of the duodenum and presented as obscure gastrointestinal hemorrhage. Radiologic, surgical, and pathologic appearances are presented.
Brunner Glands ; Duodenal Diseases/*complications/diagnosis ; Female ; Gastrointestinal Hemorrhage/*etiology ; Hamartoma/*complications/diagnosis ; Humans ; Middle Aged

Pathological proliferation of Brgnners gland is rare, and its wide range of morphologieal variations have led to confusing the terminology with considerable lack of agreement. Six cases of duodenal nodular lesions which consisted of pathological proliferation of Brunners glands were examined by light microscopy. Polypectomy was made in two cases, and the remaining 4 cases were examined with endoscopic biopsy materials. Two polypectomy specimens, 2 cm and 3 cm each in great diameters, consisted of protruded ovoid mass with broad and short stalks. Microacopically, all of 6 cases revealed thin strands of fibrous connective tissue which separated the normal-looking Brunners glands in lobules. Individual lobules were composed of groups of acini formed by cuboidal cells admixed with occasional endocrine cells. Presence of glandular and ductal configuration of the Brunners gland aside from thick, randomly arranged bundles of smooth muscle were featured without distinct relation to interlobular septa. Also, one polypectomy case disclosed the nests of fat cells interspersed with the glandular acini. One mucosal biopsy case contained not only the smooth muscle bands but also the intimate mixture of both acini and ducts. We conclude that some of heterogeneous composition of duodenal nodular proliferation of Brunners gland is indicative of a hamartomatous growth.
Adipocytes ; Biopsy ; Brunner Glands ; Connective Tissue ; Duodenum ; Endocrine Cells ; Hamartoma* ; Microscopy ; Muscle, Smooth ; Pathology

Brunner's gland hyperplasia, also known as Brunner's gland adenoma or hamartoma, is often encountered as a proliferative lesion arising from the Brunner's glands of the duodenum. This lesion has previously been described as being benign, with no malignant potential. We report a case of Brunner's gland hyperplasia that was incidentally discovered on endoscopy for evaluation of gastrointestinal bleeding. The histopathological findings of this lesion revealed a marked dysplastic and malignant changes from the normal Brunner's gland structure. Our case demonstrates the possibility of malignant potential in the natural history of Brunner's gland hyperplasia, even though its incidence is very rare.
Adenocarcinoma* ; Adenoma ; Brunner Glands ; Duodenum ; Endoscopy ; Hamartoma ; Hemorrhage ; Hyperplasia* ; Incidence ; Natural History

Cystic Brunner's gland hyperplasia is a benign lesion of the duodenum that may not be familiar to gastroenterologists because of its rarity. Moreover, cystic Brunner's gland hyperplasia with intacystic inverted growth is more uncommon lesion. Here, we report a case of cystic Brunner's gland hyperplasia in a 34-year-old man. An endoscopy of the upper digestive tract revealed the presence of a 1.2 cm sized polypoid mass of the duodenal second portion. Endoscopic submucosal dissection was performed to remove the mass. Microscopically, a cystic lesion was seen in the submucosa underneath the normal surface duodenal mucosa. Hyperplastic Brunner's glands were seen close by the cyst. The cyst was lined by a layer of columnar epithelium similar to that of Brunner's gland ducts with no cytologic atypia. Also, a part of the cyst lining was inverted into the cyst lumen with fibrovascular core. Therefore, The final diagnosis was a cystic Brunner's gland hyperplasia with intracystic inverted growth.
Adult ; Brunner Glands ; Duodenum ; Endoscopy ; Epithelium ; Gastrointestinal Tract ; Humans ; Hyperplasia ; Mucous Membrane

Brunner’s gland hamartomas are small benign lesions that are most commonly found in the bulb of the duodenum. They are very uncommon, and most are found incidentally during upper gastrointestinal series or esophagogastroduodenoscopy. The lesions tend to be asymptomatic, but patients may present with symptoms of duodenal obstruction or hemorrhage secondary to ulceration. Histologically, a Brunner's gland hamartoma consists of the components of Brunner's gland cells, as well as glandular, adipose and muscle cells. In this study, we report the case of a 30-year-old man who presented with upper gastrointestinal bleeding and obstructive symptoms due to a giant Brunner's gland hamartoma in the duodenal bulb. The hamartoma was successfully removed by endoscopic resection. No significant complications were observed. Microscopically, the lesion was found to be entirely composed of variable Brunner's glands and adipocytes.
Adipocytes ; Adult ; Brunner Glands ; Duodenal Obstruction ; Duodenum ; Endoscopy, Digestive System ; Hamartoma* ; Hemorrhage* ; Humans ; Muscle Cells ; Ulcer

Brunner's gland hamartomas are rare, benign duodenal tumors. But, they are the commonest hamartomas in the small intestine and believed to represent hyperplasia of Brunner's glands, perhaps in response to excessive gastric acid secretion. Brunner's gland hamartomas are usually smaller than 1cm and asymptomatic, incidental finding during endoscopy or radiographic examination. We report a case of large Brunner's gland hamartoma which prolapsed into gastric antrum and caused gastric outlet obstruction, and was resected by endoscopic polypectomy.
Brunner Glands ; Endoscopy ; Gastric Acid ; Gastric Outlet Obstruction* ; Hamartoma* ; Hyperplasia ; Incidental Findings ; Intestine, Small ; Pyloric Antrum

Brunner's gland adenoma is a rare benign tumor that is usually asymptomatic and it the result of a benign proliferation of the Brunner's glands of the duodenum. In symptomatic patients, the common clinical presentation is gastrointestinal bleeding and obstructive symptoms. A 48-year-old man presented with abdominal discomfort and vomiting. The endoscopic examination revealed a large pedunculated polypoid mass arising in the bulb and it was prolapsing through the pylorus into the antrum, and this all resulted in a ball-valve obstruction. After endoclips were applied at the peduncle of the mass, this polyp was simply and successfully cut with using an IT-knife without bleeding or perforation. We report here on a case of Brunner's gland adenoma that caused a ball-valve obstruction, and the tumor was removed by a simple and easy method with using endoclips and an IT-knife.
Adenoma ; Brunner Glands ; Duodenum ; Hemorrhage ; Humans ; Middle Aged ; Polyps ; Pylorus ; Vomiting

Brunner's gland hamartoma is also called Brunner's gland adenoma and Brunner's gland hyperplasia of Brunneroma, and it is a rare tumor of the duodenum. This tumor is caused by a benign proliferation of Brunner's glands, and the disease is normally present on the duodenum. These tumors arise mainly in the duodenal bulb and only rarely in the jejunum and proximal ileum. The clinical manifestations are nonspecific gastrointestinal complaints such as bloating or epigastric pain, and the tumor often gives rise to melena or obstruction. We report here on a case of a giant Brunner's gland hamartoma in a 48 year-old woman, and it was treated by endoscopic polypectomy. We also include a review of the related literatures.
Adenoma ; Brunner Glands ; Duodenum ; Female ; Gastrointestinal Hemorrhage* ; Hamartoma* ; Humans ; Hyperplasia ; Ileum ; Jejunum ; Melena ; Middle Aged