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A case of pyloric gland adenoma with high-grade dysplasia in the duodenum arising from heterotopic gastric mucosa observed over 5 years

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Abstract

Pyloric gland adenoma (PGA) in the duodenum is a rare gastric phenotype duodenal neoplasm. Although heterotopic gastric mucosa in the duodenum has been recognized as a benign lesion, it is a potential precursor of PGA and gastric phenotype adenocarcinoma. Herein, we present a case follow-up of endoscopic and histological changes in the PGA in the duodenum from low-grade to high-grade dysplasia. PGA was considered to arise from the heterotopic gastric mucosa, because the heterotopic gastric mucosa was observed in the initial examination. It is difficult to distinguish heterotopic gastric mucosa from PGAs, both endoscopically and histologically. This increase in size may be useful for their differentiation. Therefore, endoscopists should not underestimate the growth of the heterotopic gastric mucosa compared to that in the previous examination.

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Acknowledgements

We also asked Takeshi Inoue, Board Certified Pathologist of the Japanese Society of Pathology, the director of the Department of Pathology at Osaka City General Hospital, for a histopathological opinion.

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Authors and Affiliations

  1. Department of Gastroenterology, Osaka City General Hospital, 2-13-22, Miyakojima Hon-dori, Miyakojima-ku, Osaka, 534-0021, Japan

    Daiki Kitagawa, Tomoaki Yamasaki, Tetsuya Ikeda, Yuhei Sakata, Naoto Hirata, Takehisa Suekane, Satoshi Sugimori & Hiroko Nebiki

  2. Department of Pathology, Osaka City General Hospital, Osaka, Japan

    Naomi Ishii

  3. Department of Gastroenterological Surgery, Osaka City General Hospital, Osaka, Japan

    Katsunobu Sakurai

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  1. Daiki Kitagawa
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  2. Tomoaki Yamasaki
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  3. Tetsuya Ikeda
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  4. Yuhei Sakata
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  5. Naoto Hirata
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  10. Hiroko Nebiki
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Correspondence to Tomoaki Yamasaki.

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Kitagawa, D., Yamasaki, T., Ikeda, T. et al. A case of pyloric gland adenoma with high-grade dysplasia in the duodenum arising from heterotopic gastric mucosa observed over 5 years. Clin J Gastroenterol 16, 26–31 (2023). https://doi.org/10.1007/s12328-022-01721-6

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  • DOI: https://doi.org/10.1007/s12328-022-01721-6

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