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Brunner gland hyperplasia

Brunner gland hyperplasia results from disproportionate overgrowth of Brunner glands in the duodenum as a result of hyperacidity.

Hyperplasia begins at the pylorus and extends distally within the first 2/3 of the duodenum. Where the focal growth of hyperplastic cells is greater than 1cm in diameter, the hyperplastic region is referred to as Brunner gland adenoma.

There are certain morphologic types:

  • diffuse nodular hyperplasia
  • circumscribed nodular hyperplasia (superpapillary portion)
  • single adenomatous hyperplastic polyp (duodenal bulb)

Radiographic features

Fluoroscopy
  • multiple nodular filling defects (usually the 1st portion of duodenum)
  • cobblestoning
  • rarely, single large mass with central ulceration

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