’Pyloric gland-type adenoma' arising in heterotopic gastric mucosa of the duodenum, with dysplastic progression of the gastric type

1999 ◽  
Vol 435 (4) ◽  
pp. 452-457 ◽  
Author(s):  
R. Kushima ◽  
H. J. Rüthlein ◽  
M. Stolte ◽  
M. Bamba ◽  
T. Hattori ◽  
...  
Keyword(s):  
Gastric Mucosa ◽  
Heterotopic Gastric Mucosa ◽  
Pyloric Gland ◽  
Gastric Type ◽  
Gland Type

scholarly journals Symptomatic Heterotopic Gastric Mucosa in Distal Esophagus

2021 ◽  
Author(s):  
Avnish Kumar Seth ◽  
Mahesh Kumar Gupta ◽  
Gursimran Kaur ◽  
Priti Jain ◽  
Rinkesh Kumar Bansal
Keyword(s):  
Gastric Mucosa ◽  
Squamous Epithelium ◽  
Narrow Band Imaging ◽  
Distal Esophagus ◽  
Heterotopic Gastric Mucosa ◽  
Retrosternal Pain ◽  
Gastric Type ◽  
History Of ◽  
Mass Lesions

Abstract Introduction Heterotopic gastric mucosa (HGM) in esophagus is commonly noted as an inlet patch at endoscopy. We describe a rare patient with symptomatic distal esophageal HGM. Case Report A 40-year-old male presented with retrosternal pain and marked odynophagia for the last 4 weeks without any history of ingestion of antibiotics, foreign body, or corrosive. Endoscopy showed abrupt circumferential transition to salmon pink mucosa at 35 cm from incisors. From 35 to 41 cm, there were areas of polypoid edematous thickening with few superficial ulcers of 1 to 3 mm. Squamous epithelium was visualized at narrow band imaging from 41 cm to the Z-line at 43 cm with no hiatus hernia. Biopsy showed gastric-type mucosa with parietal cells without dysplasia. Serology for cytomegalovirus and human immunodeficiency virus was negative. He was managed with proton pump inhibitors (PPIs) and prokinetics and improved symptomatically. Follow-up endoscopy at 3 months demonstrated healing of ulcers with persistence of HGM and pseudopolyps. He remains well on maintenance with PPI at 1-year follow-up. Conclusion Symptomatic HGM in distal esophagus is rare and can be differentiated from Barrett’s esophagus histologically and by presence of squamous epithelium between HGM and stomach. Inflammatory mass lesions may develop and mimic esophageal malignancy. Symptoms are largely due to acid production and usually respond to PPI.

scholarly journals Duodenal Bulb Mucosa with Hypertrophic Gastric Oxyntic Heterotopia in Patients with Zollinger Ellison Syndrome

2009 ◽  
Vol 2009 ◽  
pp. 1-6 ◽  
Author(s):  
Emil Kohan ◽  
David Oh ◽  
Hank Wang ◽  
Salar Hazany ◽  
Gordon Ohning ◽  
...  
Keyword(s):  
Gastric Mucosa ◽  
Gastric Acid ◽  
Duodenal Bulb ◽  
Duodenal Mucosa ◽  
Heterotopic Gastric Mucosa ◽  
Blue Staining ◽  
Surface Epithelium ◽  
The Novel ◽  
Zollinger Ellison Syndrome ◽  
Gastric Type

Objectives. Zollinger-Ellison Syndrome (ZES) results in hypersecretion of gastric acid (via gastrinoma) leading to peptic ulcers, diarrhea, and abdominal pain. We describe the novel discovery of hypertrophic, heterotopic gastric mucosa in the proximal duodenal bulb in patients with ZES, which we hypothesize results in an increased incidence of postbulbar ulcers in patients with ZES (a mechanism previously unreported). We determined the incidence of the novel finding of duodenal gastric oxyntic hypertrophic heterotopia (GOH) in patients with ZES. Methods. Seven patients with ZES were enrolled. The diagnosis of ZES was established by hypergastrinemia, gastric acid hypersecretion, and a positive secretin test or based on biopsy specimens (evaluated via tissue staining). Basal acid output (BAO) and baseline gastrin secretion were determined by established methods. Endoscopic examinations with methylene blue staining and biopsy of the gastric and duodenal mucosa were conducted in all patients every 3–6 months for an average of 5 years. Results. The duodenal mucosa demonstrated hypertrophic GOH in 5 out of 7 patients with ZES and an intact stomach and duodenum. Biopsies from the bowel mucosa demonstrated patchy replacement of surface epithelium by gastric-type epithelium with hypertrophic oxyntic glands in the lamina propria in 5 patients. Two of the patients had no evidence of GOH in the duodenal bulb. Patients with GOH had an average serum gastrin level of 1245 pg/mL and BAO of 2.92 mEq/hr versus 724 pg/mL and 0.8 mEq/hr in patients without GOH. Conclusions. This study demonstrated the presence of duodenal mucosa with GOH in 5 out of 7 patients with ZES and an intact stomach and duodenum. The presence of hypertrophic and heterotopic gastric mucosa is proposed to result from increased gastrin levels and may contribute to the increased incidence of postbulbar ulcers in these patients.

Can heterotopic gastric mucosa present as globus pharyngeus?

2006 ◽  
Vol 120 (7) ◽  
pp. 575-578 ◽  
Author(s):  
J L Lancaster ◽  
S Gosh ◽  
R Sethi ◽  
S Tripathi
Keyword(s):  
Gastric Mucosa ◽  
Heterotopic Gastric Mucosa ◽  
Gastric Epithelium ◽  
Anatomical Site ◽  
Small Areas ◽  
Globus Pharyngeus ◽  
Number Of Factors ◽  
Gastric Type ◽  
High Incidence ◽  
History Of

We present a series of four patients presenting with symptoms leading to a provisional diagnosis of globus pharyngeus. On further investigation, they were all found to have small areas of abnormal mucosa in either their hypopharynx or proximal oesophagus, which on biopsy were reported as containing gastric-type mucosa. Following anti-reflux treatment, all patients eventually reported a cessation of symptoms. All but one patient was followed up with repeat endoscopies. We highlight the fact that biopsies reporting gastric epithelium at this anatomical site are in keeping with the diagnosis of heterotopic gastric mucosa. We review the literature and report the high incidence and natural history of this condition.Heterotopic gastric mucosa can only be diagnosed on endoscopy and is easily missed, even during such an investigation. We raise the question of whether this condition may be one of a number of factors in the aetiology of globus pharyngeus.

scholarly journals Diagnostic Value of Endoscopic and Endoscopic Ultrasound Characteristics of Duodenal Submucosal Tumour-Like Heterotopic Gastric Mucosa

2011 ◽  
Vol 25 (7) ◽  
pp. 365-367 ◽  
Author(s):  
Koichi Eguchi ◽  
Kunihiko Aoyagi ◽  
Satoshi Nimura ◽  
Shotaro Sakisaka
Keyword(s):  
Gastric Mucosa ◽  
Endoscopic Ultrasound ◽  
Diagnostic Value ◽  
Heterotopic Gastric Mucosa ◽  
Pathological Examination ◽  
Endoscopic Polypectomy ◽  
Diagnostic Features ◽  
Gastric Glands ◽  
Gastric Type ◽  
Duodenal Epithelium

OBJECTIVE: Recent studies have reported that duodenal heterotopic gastric mucosa (HGM) has been observed in 8.9% of patients who undergo esophagogastroduodenoscopy. However, there are few reports concerning the endoscopic and endoscopic ultrasound characteristics of submucosal tumour-like HGM in the duodenum.METHODS: Endoscopic, endoscopic ultrasound (EUS) and histological findings were analyzed in six patients with submucosal tumour-like HGM, which were confirmed by pathological examination of biopsy or endoscopic polypectomy specimens.RESULTS: Endoscopically, the lesions appeared as a solitary, sessile submucosal tumour-like mass with a depression at the top. In four of six patients, small granular structures were found in the depressed area of the mass. On EUS, all masses demonstrated a heterogeneous pattern, among which four patients presented anechoic areas while two patients showed no anechoic areas. All lesions were localized within the mucosa and submucosa on EUS. Histologically, they consisted of gastric glands and some dilated glands, and were covered with normal duodenal epithelium. In four of six lesions, the tumours were composed of gastric-type foveolar epithelium showing papillary growth, fundic glands and pyloric glands, while the others consisted of gastric-type foveolar epithelium and pyloric glands.CONCLUSION: A heterogeneous pattern on EUS and small granular structures on esophagogastroduodenoscopy represent valuable diagnostic features of submucosal tumour-like HGM.

scholarly journals Heterotopic gastric mucosa in the gallbladder—a rare find

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Roberto Cunha ◽  
Rafaela Parreira ◽  
Rui Quintanilha ◽  
Vítor Carneiro ◽  
Armando Medeiros ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gastrointestinal Tract ◽  
Gastric Mucosa ◽  
Histological Change ◽  
Heterotopic Gastric Mucosa ◽  
Gallbladder Polyp ◽  
Usual Location ◽  
Common Situation

Abstract It is universally known and accepted that the development of a certain type of tissue outside its usual location, like in the gastrointestinal tract, can occur. This is a relatively common situation in the upper region of the gastrointestinal tract. However, the development of gastric mucosa in the gallbladder is a rare find. The following is the case of a 22-year-old male with an 18 mm gallbladder polyp, who electively underwent a laparoscopic cholecystectomy, having been diagnosed at a histopathological level with heterotopic gastric mucosa in the gallbladder. This brief article also aims to provide a reflection on the possible evolution of neoplasms from this histological change, based on the doubts raised in literature.

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