Metastases: “Target” or bull’s-eye lesion with rounded submucosal mass; ulceration is common
CLINICAL ISSUES
• Epigastric pain is most common symptom
• No treatment needed for diffuse type
• Endoscopic or surgical resection for large hamartoma to verify histology
(Left) Spot film from an upper GI series shows multiple small submucosal filling defects in the duodenal bulb, characteristic of Brunner gland hyperplasia.
(Right) Spot film from an upper GI series shows the duodenal bulb with a “strawberry” appearance due to innumerable small, submucosal nodules of hyperplastic Brunner glands.
(Left) Spot film from an upper GI shows multiple small polypoid masses in the proximal duodenum. An endoscopic biopsy revealed hyperplasia and elements of hamartoma arising from Brunner glands.
(Right) Spot film from an upper GI demonstrates a polypoid mass within the duodenal bulb. An endoscopic biopsy and resection revealed a hamartoma of a Brunner gland. Larger, isolated lesions, as in this case, are indistinguishable from many other duodenal masses and require a biopsy.
in the duodenal bulb, characteristic of Brunner gland hyperplasia.
in the proximal duodenum. An endoscopic biopsy revealed hyperplasia and elements of hamartoma arising from Brunner glands.
within the duodenal bulb. An endoscopic biopsy and resection revealed a hamartoma of a Brunner gland. Larger, isolated lesions, as in this case, are indistinguishable from many other duodenal masses and require a biopsy.
Diffuse type (Brunner gland hyperplasia)
