Difference between revisions of "Peptic duodenitis"
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==General== | ==General== | ||
* | *''Peptic duodenitis'' is a somewhat controversial type of [[chronic duodenitis]]. | ||
*Considered to be a consequence of [[peptic ulcer disease]] ([[Helicobacter gastritis]]). | *Considered to be a consequence of [[peptic ulcer disease]] ([[Helicobacter gastritis]]). | ||
*One of the key components of the diagnosis is foveolar metaplasia and it is disputed that this is really due to Helicobacter. | *One of the key components of the diagnosis is foveolar metaplasia and it is disputed that this is really due to Helicobacter. | ||
Revision as of 12:45, 3 May 2016
Peptic duodenitis is controversial type of chronic duodenitis.
This article deals with that controversy and foveolar metaplasia of the duodenum.
General
- Peptic duodenitis is a somewhat controversial type of chronic duodenitis.
- Considered to be a consequence of peptic ulcer disease (Helicobacter gastritis).
- One of the key components of the diagnosis is foveolar metaplasia and it is disputed that this is really due to Helicobacter.
- Genta et al. consider gastric foveolar metaplasia a congenital lesion.[1]
Microscopic
Features:[2]
- Gastric foveolar metaplasia - key feature.
- Brunner's gland hyperplasia.
- +/-Inflammation - neutrophils.[citation needed]
- Ulceration.[citation needed]
DDx:
- Chronic duodenitis not otherwise specified - no foveolar metaplasia, abundant plasma cells.
- Acute duodenitis.
- Brunner's gland hyperplasia.
- Gastric heterotopia of the duodenum.
Images
Duodenum with foveolar metaplasia - low mag. (WC/Nephron)
Duodenum with foveolar metaplasia - intermed. mag. (WC/Nephron)
Duodenum with foveolar metaplasia - very high mag. (WC/Nephron)
Stains
Foveolar metaplasia:
- PAS stain +ve.[2]
- Mucicarmine stain +ve.
Sign out
Foveolar metaplasia only
DUODENUM, BIOPSY: - SMALL BOWEL MUCOSA WITH FOCAL GASTRIC FOVEOLAR METAPLASIA. - BRUNNER'S GLANDS NOT IDENTIFIED. - VILLI AND INTRAEPITHELIAL LYMPHOCYTES WITHIN NORMAL LIMITS (NEGATIVE FOR CELIAC DISEASE). - NEGATIVE FOR ACUTE DUODENITIS. - NEGATIVE FOR DYSPLASIA.
DUODENUM, BIOPSY: - SMALL BOWEL MUCOSA WITH FOCAL GASTRIC FOVEOLAR METAPLASIA. - BRUNNER'S GLANDS NOT IDENTIFIED. - NEGATIVE FOR ACUTE DUODENITIS. - NEGATIVE FOR DYSPLASIA.
Chronic duodenitis
Duodenum, Biopsy: - Small bowel mucosa with Brunner’s gland in the lamina propria and gastric foveolar metaplasia, consistent with chronic duodenitis. - NEGATIVE for acute duodenitis. - NEGATIVE for dysplasia and NEGATIVE for malignancy.
DUODENUM, BIOPSY: - SMALL BOWEL MUCOSA WITH BRUNNER'S GLAND IN THE LAMINA PROPRIA AND GASTRIC FOVEOLAR METAPLASIA -- CONSISTENT WITH CHRONIC DUODENITIS. - NEGATIVE FOR ACUTE DUODENITIS. - NEGATIVE FOR MALIGNANCY.
DUODENUM, BIOPSY: - SMALL BOWEL MUCOSA WITH PROMINENT BRUNNER'S GLANDS AND FOCAL GASTRIC FOVEOLAR METAPLASIA. - NEGATIVE FOR ACUTE INFLAMMATION. - NEGATIVE FOR DYSPLASIA.
Micro
The sections show small bowel mucosa and a small amount of submucosa. Brunner's glands are abundant and found focally in the lamina propria. Gastric foveolar-type epithelium is identified. Intraepithelial neutrophils are not identified.
The epithelium matures appropriately. There is no increase in intraepithelial lymphocytes.
See also
References
- ↑ Genta, RM.; Kinsey, RS.; Singhal, A.; Suterwala, S. (Nov 2010). "Gastric foveolar metaplasia and gastric heterotopia in the duodenum: no evidence of an etiologic role for Helicobacter pylori.". Hum Pathol 41 (11): 1593-600. doi:10.1016/j.humpath.2010.04.010. PMID 20656325.
- ↑ 2.0 2.1 Iacobuzio-Donahue, Christine A.; Montgomery, Elizabeth A. (2005). Gastrointestinal and Liver Pathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 145. ISBN 978-0443066573.