PMC4435374_01
Black speckled pigmentation of the duodenal mucosa shown on EGD.
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F1
EGD showed black speckled pigmentation of the duodenal mucosa (Figure 1).
Lamina propria slide showing plasma cells, lymphocytes, and pigmented macrophages consistent with pseudomelanosis duodeni.
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F2
Duodenal biopsy revealed hemosiderin deposition in the lamina propria of the duodenum, consistent with a diagnosis of pseudomelanosis duodeni (PMD; Figure 2).
Blue pigmentation on iron Prussian stain of pseudomelanosis duodeni confirming that the pigment is iron.
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F3
While melanosis coli is secondary to accumulation of lipofuscin in the macrophages of the lamina propria, the predominant pigments deposited in PMD are iron sulfide and hemosiderin (Figure 3).