J Pathol Transl Med.  2018 May;52(3):179-182. 10.4132/jptm.2017.10.09.

Duodenal Adenocarcinoma of Brunner Gland Origin: A Case Report

• Moon JH
• Lee K
• Yang HK
• Kim WH

• KMID: 2412930
• DOI: http://doi.org/10.4132/jptm.2017.10.09

Abstract

We report a case of adenocarcinoma originating from the duodenal Brunner glands in a 47-year-old female patient. The lesion was 0.8 cm in extent and located at the posterior wall of the first part of the duodenum. Histologically, the tumor showed transition from non-neoplastic Brunner glands through dysplastic epithelium into adenocarcinoma. The carcinoma cells were strongly positive for MUC6 protein, which is an epithelial marker for the Brunner glands. Tumor protein p53 was overexpressed in the carcinoma cells, but not in the non-neoplastic or dysplastic epithelium. Dystrophic calcification was predominant. This is the first case report of duodenal adenocarcinoma of Brunner gland origin in Korea.

Keyword

Brunner glands; Adenocarcinoma; Duodenum

MeSH Terms

Adenocarcinoma*
Brunner Glands*
Duodenum
Epithelium
Female
Humans
Korea
Middle Aged

Figure

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  Fig. 1. Gross and microscopic images of Brunner gland adenocarcinoma. (A) Endoscopy of the duodenal carcinoma showing a 0.8-cm lesion with central depression in the posterior wall of the first segment of duodenum. (B) Gross view. (C) Microscopic image of the endoscopic biopsy showing well-differentiated adenocarcinoma consisting of branching glands. (D) High-power view demonstrates psammoma-like structures of dystrophic calcification.

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  Fig. 2. Histology and immunohistochemistry of the lesion. (A) Low power view of resected duodenal segment. (B) Higher power view of adenocarcinoma. (C) MUC6 stain showed diffuse positivity in adenocarcinoma as well as adjacent Brunner glands. (D) Negative p53 staining in normal Brunner glands. (E) Focal positive p53 staining in dysplasia. (F) Strong p53 staining in adenocarcinoma.

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