PMC6277137_01
(A and B) Esophagogastroduodenoscopy of the second part of the duodenum showing a sessile polyp with a central depression. (C) Snare polypectomy of lesion. (D) Site after successful polypectomy.
CG-CGCR180065F001.jpg
PMC6277137_01_CG-CGCR180065F001.jpg
F1
EGD after admission was notable for a 12-mm sessile polyp with a central depression in the second portion of the duodenum, opposite the major papilla (Figure 1).
Histological images of Brunner's gland hyperplasia in the duodenum. (A) Low-power view showing the adenoma between the asterisks * and the clear margins (arrows). (B) High-power view showing prominent mitoses (yellow arrow), increased apoptosis (blue arrow), and cytological atypia.
CG-CGCR180065F002.jpg
PMC6277137_01_CG-CGCR180065F002.jpg
F2
Pathological examination revealed Brunner's gland adenoma with oncocytic features and focal high grade dysplasia (HGD) characterized by increased mitoses and cytological atypia, with negative resection margins for HGD and no evidence of submucosal invasion (Figure 2).