PMC8565714_01
Endoscopic image showing small sessile polyps (2-3 mm), located in the duodenal bulb and second part of the duodenum. Courtesy of ENGIP
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Upper endoscopy revealed: grade I-II esophageal varices, severe portal hypertensive gastropathy, small, multiple duodenal polyps - 2-3 mm, located in the duodenal bulb and second part of the duodenum (Figure 1).
Duodenal mucosa with preserved villous architecture, with some enlarged villi. There is no pathologic inflammation and no epithelial dysplasia (HE, x100). Courtesy of ENGIP.
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Microscopically, the polypoid duodenal mucosa presented preserved villous architecture, with some enlarged villi (Figure 2), foveolar metaplasia of the surface epithelium and numerous ectatic and congested capillaries in the lamina propria (Figure 3).
Numerous ectatic capillaries in lamina propria. Gastric foveolar metaplasia of the surface duodenal epithelium. (HE, x200). Courtesy of ENGIP.
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Microscopically, the polypoid duodenal mucosa presented preserved villous architecture, with some enlarged villi (Figure 2), foveolar metaplasia of the surface epithelium and numerous ectatic and congested capillaries in the lamina propria (Figure 3).
Endothelial cells of blood and lymphatic vessels were positive for CD 34 and D2-40, respectively (IHC, anti CD34 Ab and anti D2-40 Ab, x100). Courtesy of ENGIP.
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Immunohistochemistry tests were performed: CD34 and D2-40 were positive in the endothelium of proliferating blood vessels and lymphatics in the lamina propria (Figure 4).
Low proliferation index (Ki 67), predominantly in the duodenal crypts (IHC, anti-Ki67 Ab, x200). Courtesy of ENGIP.
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Ki 67 proliferation index was <1% (Figure 5).