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Gastroenterologia Japonica

, Volume 28, Issue 1, pp 118–125 | Cite as

Carcinoma of duodenal bulb arising from the Brunner’s gland

  • Minoru Itsuno
  • Kazuya Makiyama
  • Katsuhisa Omagari
  • Toshirou Tanaka
  • Kouhei Hara
  • Nobuo Tsuda
  • Youichi Ajioka
  • Hidenobu Watanabe
Case Reports
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Abstract

A 75-year-old man was diagnosed as having a sessile tumor measuring 1.4 x 1.0 cm in size in the duodenal bulb after upper gastroduodenal series. The biopsy specimens revealed a proliferation of the adenomatous glands showing an acinar structure with papillary infolding; type III mucus, which is characteristic of Brunner’s glands. Antral glands and mucus neck cells of the fundic glands were also observed in the adenomatous glands by concanavalin A staining. Thus, it was clear that the tumor had originated from the Brunner’s glands. Three years and four months later, the sessile tumor had developed into a fungating ulcerated tumor via a polypoid form. The biopsy specimens revealed a papillary adenocarcinoma with foci of undifferentiated carcinoma. Retrospectively, the adenomatous glands in the biopsy taken from the sessile tumor should have been regarded as low grade carcinoma. Therefore, we propose that when a polyp or tumor shows an increase in size or change in macroscopic appearance, surgery should be considered.

Key words

Brunner’s gland carcinoma duodenal bulb concanavalin A staining 

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Copyright information

© The Japanese Society of Gastroenterology 1993

Authors and Affiliations

  • Minoru Itsuno
    • 1
  • Kazuya Makiyama
    • 1
  • Katsuhisa Omagari
    • 1
  • Toshirou Tanaka
    • 1
  • Kouhei Hara
    • 1
  • Nobuo Tsuda
    • 2
  • Youichi Ajioka
    • 3
  • Hidenobu Watanabe
    • 3
  1. 1.Second Department of Internal MedicineNagasaki University School of MedicineNagasakiJapan
  2. 2.Central Diagnostic LaboratoryNagasaki University School of MedicineNagasakiJapan
  3. 3.First Department of PathologyNiigata University School of MedicineNiigataJapan

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