Difference between revisions of "Gastric heterotopia of the duodenum"

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{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Gastric heterotopia in the duodenum -- high mag.jpg
| Width      =
| Caption    = Gastric heterotopia in the duodenum. [[H&E stain]].
| Synonyms  =
| Micro      = foveolar epithelium, gastric glands (body-type or antral-type), small bowel mucosa +/-Brunner's glands
| Subtypes  =
| LMDDx      = foveolar metaplasia of the duodenum, foveolar gastric-type dysplasia, [[intestinal metaplasia of the stomach]]
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      = nodules/polyps
| Grossing  =
| Staging    =
| Site      = [[duodenum]]
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = relatively common ~15%
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = benign
| Other      =
| ClinDDx    = duodenal polyp, duodenal ulcer, tumour/submucosal tumour, [[duodenal carcinoma]], [[duodenitis]]
| Tx        =
}}
'''Gastric heterotopia of the duodenum''' is a relatively common finding of the [[duodenum]].
'''Gastric heterotopia of the duodenum''' is a relatively common finding of the [[duodenum]].


==General==
==General==
*Common ~15% of cases in one series.<ref name=pmid22295146>{{Cite journal  | last1 = Terada | first1 = T. | title = Pathologic observations of the duodenum in 615 consecutive duodenal specimens: I. benign lesions. | journal = Int J Clin Exp Pathol | volume = 5 | issue = 1 | pages = 46-51 | month =  | year = 2012 | doi =  | PMID = 22295146 }}</ref>
*Common ~15% of cases in one series.<ref name=pmid22295146>{{Cite journal  | last1 = Terada | first1 = T. | title = Pathologic observations of the duodenum in 615 consecutive duodenal specimens: I. benign lesions. | journal = Int J Clin Exp Pathol | volume = 5 | issue = 1 | pages = 46-51 | month =  | year = 2012 | doi =  | PMID = 22295146 }}</ref>
*Probably not related to [[Helicobacter pylori]].<ref name=pmid20656325>{{Cite journal  | last1 = Genta | first1 = RM. | last2 = Kinsey | first2 = RS. | last3 = Singhal | first3 = A. | last4 = Suterwala | first4 = S. | title = Gastric foveolar metaplasia and gastric heterotopia in the duodenum: no evidence of an etiologic role for Helicobacter pylori. | journal = Hum Pathol | volume = 41 | issue = 11 | pages = 1593-600 | month = Nov | year = 2010 | doi = 10.1016/j.humpath.2010.04.010 | PMID = 20656325 }}</ref>
*Probably ''not'' caused by ''[[Helicobacter pylori]]''.<ref name=pmid20656325>{{Cite journal  | last1 = Genta | first1 = RM. | last2 = Kinsey | first2 = RS. | last3 = Singhal | first3 = A. | last4 = Suterwala | first4 = S. | title = Gastric foveolar metaplasia and gastric heterotopia in the duodenum: no evidence of an etiologic role for Helicobacter pylori. | journal = Hum Pathol | volume = 41 | issue = 11 | pages = 1593-600 | month = Nov | year = 2010 | doi = 10.1016/j.humpath.2010.04.010 | PMID = 20656325 }}</ref>
**''[[Helicobacter duodenitis]]'' is associated with gastric metaplasia.<ref name=pmid7769188>{{cite journal |authors=Yang H, Dixon MF, Zuo J, Fong F, Zhou D, Corthésy I, Blum A |title=Helicobacter pylori infection and gastric metaplasia in the duodenum in China |journal=J Clin Gastroenterol |volume=20 |issue=2 |pages=110–2 |date=March 1995 |pmid=7769188 |doi=10.1097/00004836-199503000-00007 |url=}}</ref>
 
Clinical DDx:<ref name=pmid21242038/>
*Duodenal polyp, duodenal ulcer, tumour/submucosal tumour, [[duodenal carcinoma]], and [[duodenitis]].
 
===Classification===
According to Terada it can be subdivided into:<ref name=pmid21242038>{{Cite journal  | last1 = Terada | first1 = T. | title = Heterotopic gastric mucosa of the gastrointestinal tract: a histopathologic study of 158 cases. | journal = Pathol Res Pract | volume = 207 | issue = 3 | pages = 148-50 | month = Mar | year = 2011 | doi = 10.1016/j.prp.2010.12.004 | PMID = 21242038 }}</ref>
#Foveolar epithelium with gastric pits
#Foveolar epithelium only.
 
Note:
*This article considers the former (foveolar epithelium with gastric pits) as gastric heterotopia. The later (foveolar epithelium only) is dealt with in the context of [[peptic duodenitis]]. <!-- ''foveolar metaplasia of the duodenum'' -->


==Gross==
==Gross==
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#Foveolar epithelium.
#Foveolar epithelium.
#Gastric glands - body-type or antral-type.
#Gastric glands - body-type or antral-type.
#Small bowel mucosa +/- Brunner's glands.


DDx:
DDx:
*Foveolar metaplasia (isolated) - see [[chronic duodenitis]].
*Foveolar metaplasia (isolated) - see [[peptic duodenitis]].
*Foveolar gastric-type dysplasia.<ref>{{Cite journal  | last1 = Park | first1 = do Y. | last2 = Srivastava | first2 = A. | last3 = Kim | first3 = GH. | last4 = Mino-Kenudson | first4 = M. | last5 = Deshpande | first5 = V. | last6 = Zukerberg | first6 = LR. | last7 = Song | first7 = GA. | last8 = Lauwers | first8 = GY. | title = Adenomatous and foveolar gastric dysplasia: distinct patterns of mucin expression and background intestinal metaplasia. | journal = Am J Surg Pathol | volume = 32 | issue = 4 | pages = 524-33 | month = Apr | year = 2008 | doi = 10.1097/PAS.0b013e31815b890e | PMID = 18300795 }}</ref>
*Foveolar gastric-type dysplasia.<ref>{{Cite journal  | last1 = Park | first1 = do Y. | last2 = Srivastava | first2 = A. | last3 = Kim | first3 = GH. | last4 = Mino-Kenudson | first4 = M. | last5 = Deshpande | first5 = V. | last6 = Zukerberg | first6 = LR. | last7 = Song | first7 = GA. | last8 = Lauwers | first8 = GY. | title = Adenomatous and foveolar gastric dysplasia: distinct patterns of mucin expression and background intestinal metaplasia. | journal = Am J Surg Pathol | volume = 32 | issue = 4 | pages = 524-33 | month = Apr | year = 2008 | doi = 10.1097/PAS.0b013e31815b890e | PMID = 18300795 }}</ref>
*[[Stomach with intestinal metaplasia]].


===Images===
===Images===
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==Sign out==
==Sign out==
<pre>
Duodenum, Biopsy:
- Duodenal mucosa with gastric (body-type) heterotopia, otherwise within normal limits.
</pre>
===Block letters===
<pre>
<pre>
  DUODENUM, BIOPSY:
  DUODENUM, BIOPSY:
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</pre>
</pre>


===Alternate===
====Alternate====
<pre>
<pre>
DUODENUM, BIOPSY:
DUODENUM, BIOPSY:
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*[[Duodenum]].
*[[Duodenum]].
*[[Stomach]].
*[[Stomach]].
*[[Gastric heterotopia]].
*[[Pseudopyloric mucous glands]].


==References==
==References==

Latest revision as of 18:47, 5 February 2024

Gastric heterotopia of the duodenum
Diagnosis in short

Gastric heterotopia in the duodenum. H&E stain.
LM foveolar epithelium, gastric glands (body-type or antral-type), small bowel mucosa +/-Brunner's glands
LM DDx foveolar metaplasia of the duodenum, foveolar gastric-type dysplasia, intestinal metaplasia of the stomach
Gross nodules/polyps
Site duodenum
Prevalence relatively common ~15%
Prognosis benign
Clin. DDx duodenal polyp, duodenal ulcer, tumour/submucosal tumour, duodenal carcinoma, duodenitis

Gastric heterotopia of the duodenum is a relatively common finding of the duodenum.

General

Clinical DDx:[4]

Classification

According to Terada it can be subdivided into:[4]

  1. Foveolar epithelium with gastric pits
  2. Foveolar epithelium only.

Note:

  • This article considers the former (foveolar epithelium with gastric pits) as gastric heterotopia. The later (foveolar epithelium only) is dealt with in the context of peptic duodenitis.

Gross

  • Typically nodules/polyps.[5]

Microscopic

Features:

  1. Foveolar epithelium.
  2. Gastric glands - body-type or antral-type.
  3. Small bowel mucosa +/- Brunner's glands.

DDx:

Images

  • GH - low mag. (WC)

  • GH - intermed. mag. (WC)

  • GH - high mag. (WC)

www:

Sign out

Duodenum, Biopsy:
	- Duodenal mucosa with gastric (body-type) heterotopia, otherwise within normal limits.

Block letters

 DUODENUM, BIOPSY:
- SMALL BOWEL MUCOSA WITH GASTRIC (BODY-TYPE) HETEROTOPIA.
- NEGATIVE FOR SIGNIFICANT PATHOLOGY.

Alternate

DUODENUM, BIOPSY:
- SMALL BOWEL MUCOSA AND BRUNNER'S GLANDS WITHIN NORMAL LIMITS.
- GASTRIC HETEROTOPIA, BODY-TYPE MUCOSA.

See also

References

  1. ↑ 1.0 1.1 Terada, T. (2012). "Pathologic observations of the duodenum in 615 consecutive duodenal specimens: I. benign lesions.". Int J Clin Exp Pathol 5 (1): 46-51. PMID 22295146.
  2. ↑ 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.
  3. ↑ Yang H, Dixon MF, Zuo J, Fong F, Zhou D, Corthésy I, Blum A (March 1995). "Helicobacter pylori infection and gastric metaplasia in the duodenum in China". J Clin Gastroenterol 20 (2): 110–2. doi:10.1097/00004836-199503000-00007. PMID 7769188.
  4. ↑ 4.0 4.1 Terada, T. (Mar 2011). "Heterotopic gastric mucosa of the gastrointestinal tract: a histopathologic study of 158 cases.". Pathol Res Pract 207 (3): 148-50. doi:10.1016/j.prp.2010.12.004. PMID 21242038.
  5. ↑ Shousha, S.; Spiller, RC.; Parkins, RA. (Jan 1983). "The endoscopically abnormal duodenum in patients with dyspepsia: biopsy findings in 60 cases.". Histopathology 7 (1): 23-34. PMID 6840712.
  6. ↑ Park, do Y.; Srivastava, A.; Kim, GH.; Mino-Kenudson, M.; Deshpande, V.; Zukerberg, LR.; Song, GA.; Lauwers, GY. (Apr 2008). "Adenomatous and foveolar gastric dysplasia: distinct patterns of mucin expression and background intestinal metaplasia.". Am J Surg Pathol 32 (4): 524-33. doi:10.1097/PAS.0b013e31815b890e. PMID 18300795.
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