Brunner gland hyperplasia results from a disproportionate overgrowth of Brunner glands in the duodenum as a result of hyperacidity.
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Pathology
Brunner gland hyperplasia begins at the pylorus and extends distally within the first two-thirds of the duodenum. Where the focal growth of hyperplastic cells is greater than 1 cm 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 the duodenum)
rarely a single large mass with central ulceration
Differential diagnosis
duodenitis: fold thickening with nodularity and erosions are specific findings