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PubMed2002

High-grade B-cell lymphoma arising in mucosa-associated lymphoid tissue of the duodenum.

Duodenal mucosa-associated lymphoid tissue lymphoma is a rare neoplasm. We report a case of a 70-year-old man with non-Hodgkin's lymphoma located in the descending duodenum that was not associated with Helicobacter pylori infection of the stomach. A surgical resection due to obstruction of the bowel lumen above the ligament of Treitz was performed. No invasion into the adjacent structure was confirmed at surgery. The pathological examination showed an infiltration of the duodenal mucosa and submucosa with B lymphocytes. Monoclonal proliferation of the lymphoid tissue was demonstrated by polymerase chain reaction. The histological appearance and the demonstration of monoclonality fulfilled the criteria for malignant high-grade B-cell lymphoma arising from mucosa-associated lymphoid tissue.

Aged↗
PubMed1991

The effect of interferon on carcinogenesis by N-ethyl-N'-nitro-N-nitrosoguanidine in the duodenum of mice.

The inhibitory effect of murine interferon alpha/beta (Mu-IFN) on the induction of adenocarcinoma of the duodenum in C57BL/6 mice given N-ethyl-N'-nitro-N-nitrosoguanidine (ENNG) was examined. ENNG was given continuously in drinking water for 4 weeks and Mu-IFN was given intraperitoneally for 12 weeks. Then, the duodenal tumors of mice were examined stereomicroscopically and histologically. The level of IFN activity and natural killer (NK) activity were evaluated after an intraperitoneal single injection of Mu-IFN, and the level of NK activity was evaluated 2, 5 and 8 weeks after giving ENNG and Mu-IFN. In the mice given Mu-IFN, the incidence of duodenal tumors was significantly decreased (P less than 0.01), compared with that in mice given ENNG alone. Further, anti-asialo GM1 was given intraperitoneally every 5 days for 8 weeks to depress NK function and the incidence and size of duodenal tumors were examined. The results indicated that NK cells also have an important effect on the process of carcinogenesis. These data suggest that chemoprevention with IFN may be feasible.

Adenocarcinoma↗
PubMed1982

Villous adenoma of the duodenum: cellular composition and histochemical findings.

A villous adenoma of the duodenum was studied histologically and histochemically by semi-thin sections using glycol-methacrylate as embedding medium. All the four epithelial cell types which are present in normal duodenal mucosa (absorptive columnar, goblet, Paneth, endocrine) were found in the tumour, as well as undifferentiated elements. Neutral and acid non-sulphated mucins were detected. Cell type distribution and mucin production varied according to the degree of differentiation. Foci of gastric metaplasia were observed. A possible histogenesis from crypt base stem cell is considered.

Adenoma↗
PubMed1982

A comparative electron microscopic study of leiomyosarcoma and leiomyoma of the duodenum.

Comparison of ultrastructural features between leiomyosarcoma and leiomyoma of the duodenum was made. There was no absolute difference between the two, but the following ultrastructural features of leiomyosarcoma were different from leiomyoma: (1) occasional conglomerations of mitochondria surrounded by granular endoplasmic reticulum; (2) quite rare presence of single cilia; (3) frequent occurrence of intranuclear inclusion bodies; (4) variability in nuclear size and shape; and (5) wide interstitial space with scanty collagen fibrils. Although both tumors were considered to be of smooth muscle origin, their ultrastructural features were distinctively different from the normal smooth muscle in some points. In addition to the light microscopic findings, ultrastructural features were considered to be valuable for distinguishing the malignant from the benign smooth muscle tumors in the gastrointestinal tract.

Cell Membrane↗
PubMed1992

An immunohistochemical and ultrastructural study of case of small-cell neuroendocrine carcinoma in the ampullary region of the duodenum.

One case of small-cell neuroendocrine carcinoma in the ampullary region of the duodenum is reported. The histological appearance of the tumor was identical to pulmonary small-cell carcinoma. Neuroendocrine differentiation was demonstrated immunohistochemically by positive immunoreaction for neuron specific enolase, Leu-7 and chromogranin, and ultrastructurally by the presence of scanty dense-core neurosecretory type granules. Small-cell neuroendocrine carcinoma in the ampulla of Vater is extremely rare. To our knowledge, this is the sixth reported case.

Ampulla of Vater↗
PubMed1977

Leiomyosarcoma of the duodenum: a report of three cases.

Three cases of leiomyosarcoma of the duodenum are reported in this paper. The first patient demonstrated the development of a leiomyosarcoma from a leiomyoma, and also posed diagnostic problems as a Pólya gastrectomy had previously been performed. The second patient presented with acute pancreatitis--a hitherto unreported complication of this condition. The third patient showed that even though the primary tumour was unresectable, the patient remained well for more than a year after diagnosis.

Acute Disease↗
PubMed1979

Primary isolated extramedullary plasmacytoma of the duodenum.

The first case of primary isolated extramedullary plasmacytoma (EMP) of the duodenum is reported. The features which differentiate primary isolated EMPs from EMPs associated with multiple myeloma are discussed. The prognosis for a primary isolated EMP of the gastrointestinal tract is uncertain.

Aged↗
PubMed1998

Strictureplasty with a pedunculated jejunal patch in Crohn's disease of the duodenum.

Surgical treatment for duodenal stenosis caused by Crohn's disease is only indicated in symptomatic duodenal obstruction when conservative treatment has failed. Previously described operative procedures include strictureplasty for short stenoses and bypass or resectional procedures, if duodenal stenosis is extensive. In this case of an extensive duodenal Crohn's stenosis, we performed a strictureplasty of the duodenum with a pedunculated jejunal patch. Thus, duodenal passage could be well preserved, and the patient has remained asyptomatic during a follow-up of more than 9 months.

Adult↗
PubMed1974

Two types of neurones in the myenteric plexus of duodenum in the guinea-pig.

1. Intracellular recordings have been made from neurones lying in the myenteric plexus of guinea-pig duodenum; some aspects of their membrane properties have been studied by passing current through the intracellular electrode while recording changes in membrane potential.2. The current-voltage relationship was linear for small changes in membrane potential, input resistances ranging from 125 to 250 MOmega. Larger hyperpolarizing currents (causing changes of 20-40 mV) caused the input resistance to fall.3. Depolarizing currents of 1 to 10 x 10(-10) A initiated action potentials with amplitudes of up to 95 mV.4. Two types of cell were distinguished when an action potential was initiated. In one group the action potential and undershoot had a form similar to that recorded from other mammalian ganglia. In the second group an action potential was followed by both an undershoot and a prolonged afterhyperpolarization which was associated with a decrease in cell resistance.5. The two groups of cells were further distinguished by their responses to transmural stimulation. Only those cells which did not show an afterhyperpolarization could be shown to receive a synaptic input.6. The mechanism by which each cell type generates an action potential was different. The action potentials recorded from cells which had a detectable synaptic input were abolished by tetrodotoxin. In contrast, those recorded from the other type of cells persisted in the presence of tetrodotoxin. Preliminary experiments suggest that during an action potential these cells become permeable to both sodium and calcium ions.7. Abolition of the calcium component of the action potential in cells which generated an afterhyperpolarization abolished this latter potential.8. The role of these two groups of cells is discussed.

Journal Article↗
PubMed1989

Alimentary tract and pancreas. Stimulation of mucosal prostaglandin synthesis in human stomach and duodenum by antacid treatment.

The effect of a low dose antacid treatment on mucosal prostaglandin metabolism was studied in 15 healthy volunteers. A daily dose of 46 mmol (= 138 mval) Al(OH)3 and 42 mmol (= 84 mval) Mg(OH)2 with a titrated in vitro neutralising capacity of 272 mval of H+ was given for three weeks. Total prostaglandin formation and the prostaglandin profile as well as the degradation of PGE2 were assayed by incubating homogenates of endoscopic biopsies from antral and duodenal mucosa with the precursor (14C)arachidonic acid. Total prostaglandin synthesis in antrum (623 (110) pmol/mg protein) and duodenum (432 (72) pmol/mg) was stimulated after three weeks administration of low dose antacids by 176% (p less than 0.05) and 154% (p less than 0.05), respectively. An untreated control group exhibited no significant changes. In contrast, the prostaglandin profile showed only a small increase of the prostacyclin metabolite 6-keto PGF1a (p less than 0.05) at the expense PGD2. PGE2 catabolism was unaffected. This enhanced activity of mucosal prostaglandin cyclooxygenase might represent one possible mechanism of action of a low dose antacid treatment.

Aluminum Hydroxide↗
PubMed1993

Diffuse vascular ectasia of the antrum, duodenum, and jejunum in a patient with nodular regenerative hyperplasia. Lack of response to portosystemic shunt or gastrectomy.

The case is reported of a 70 year old man who presented with severe anaemia because of chronic gastrointestinal blood loss. This loss was ascribed to vascular ectasia resembling the gastric antral vascular ectasia syndrome but extended to include the antrum, the duodenum, the jejunum, and, possibly, the cardiac area. This condition was associated with portal hypertension as a result of nodular regenerative hyperplasia. Consecutive treatments including sucralfate, prostaglandin E2, propranolol, organic nitrates, pentoxyphilline, corticosteroids, endoscopic sclerotherapy, portosystemic shunt, total gastrectomy, proved ineffective.

Aged↗
PubMed1966

Pedunculated islet-cell tumour of the duodenum.

An unusual islet-cell tumour found at necropsy in a patient who had died from a myocardial infarction is described. Of particular interest were the pedunculated nature and large size of the tumour. The clinical features of the case are considered. Four islet-cell tumours in the duodenum have previously been reported and it seems probable that such tumours arise in heterotopic pancreas.

Adenoma, Islet Cell↗
PubMed2006

Hyperplastic polyps of the duodenum: an unusual histological finding.

A 58-year-old man underwent upper gastrointestinal surveillance endoscopy for Barrett's oesophagus. This showed a possible gastric ulcer, although histological examination was normal. Follow-up endoscopy showed white ridges in the distal duodenum and these were subjected to biopsy. Histological examination of the biopsy specimens showed polypoid duodenal mucosa showing features similar to those of a hyperplastic polyp of the colon. In addition, the mucosal surface was focally of gastric surface type. The features were interpreted overall as most likely to represent an unusual form of regenerative change in the setting of previous chronic inflammatory mucosal damage. The case is presented as an unusual histological phenomenon at this site; it would be important not to overdiagnose neoplasia in this situation.

Barrett Esophagus↗
PubMed1982

Heterotopic gastric mucosa in the duodenum.

Thirteen patients are described who, on routine endoscopy of the upper gastrointestinal (GI) tract, were found to show a characteristic appearance in the proximal duodenum. This consisted of multiple small mucosal nodules, predominantly in the anterior wall. All cases were biopsied, and showed identical histological appearances of heterotopic gastric mucosa of body type. The incidence of this condition is probably much higher than reported previously, and may be present in up to 2% of the population. In all our patients a diagnosis was reached, other than heterotopic gastric mucosa, to explain the GI tract symptoms. In none was a healed or active duodenal ulcer evident and in none was there a history of a pre-existing ulcer. In our opinion these nodules are probably of little or no clinical significance.

Adult↗
PubMed1994

Evidence for adenoma-carcinoma sequence in the duodenum of patients with familial adenomatous polyposis. The Leeds Castle Polyposis Group (Upper Gastrointestinal Committee).

AIMS: To explore the association between duodenal adenoma and carcinoma in patients with familial adenomatous polyposis (FAP). METHODS: A multicentre survey of 1262 patients with FAP yielded 47 cases of duodenal cancer. The association between adenoma and cancer was assessed in these cases. RESULTS: Adenomatous tissue was found within duodenal cancer in 29 of 44 (66%) patients with FAP and in mucosa adjacent to duodenal cancer in 31 of 42 (73%) such patients. Adenomas were found as a component of, or adjacent to, duodenal cancer in 38 of 45 (84%) patients. CONCLUSIONS: These observations support the existence of the adenomacarcinoma sequence in the duodenum of patients with FAP. Factors associated with malignant change included villous histology, moderate or severe dysplasia, and the presence of stage IV duodenal polyposis.

Adenoma↗
PubMed1980

Dual primary adenocarcinoma of the duodenum and jejunum in a patient with previous colonic cancers.

Primary adenocarcinoma of the small intestine is an uncommon tumour, the incidence being 40-60 times less frequent than carcinoma of the colon. Multiple primary neoplasia of the small bowel, although not infrequently seen with benign growths, is an extremely rare event with malignant lesions. A patient is described who had an adenocarcinoma of the duodenum and jejunum, with a previous history of colonic carcinomas. The case is discussed together with a brief review of the literature.

Adenocarcinoma↗
PubMed1980

Extension of gastric lymphoma into the esophagus and duodenum.

In 81 patients with gastric lymphoma, spread of tumor beyond the stomach was analyzed based on radiographs and medical records. Tumor extension into the esophagus was present in 10% of patients, and spread across the pylorus into the duodenal bulb was seen in 33%. When the gastric fundus alone was involved, transcardial extension was seen in four of 10 patients, and when only the antrum was involved, transcardial extension was seen in four of 10 patients, and when only the antrum was involved, transpyloric extension was present in six of seven patients. One-third of the patients with gastric lymphoma secondary to disease in adjacent structures had contiguous involvement of the esophagus or duodenum. This study shows that transcardial extension cannot be used to differentiate gastric lymphoma from adenocarcinoma, and its confirms the frequent occurrence of transpyloric tumor extension in patients with gastric lymphoma.

Adenocarcinoma↗