PMC5339521_01
EGD showing 2 cm deeply cratered ulcer in the second portion of the duodenum, suspicious for ZES.
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Grade D), diffuse erythematous mucosa throughout the entire stomach, and a 2 cm deeply cratered ulcer in the second portion of the duodenum (D2) (Figure 1). Gastric and duodenal biopsies were consistent with severe, active chronic gastritis and duodenitis without evidence of malignancy.
Somatostatin receptor scintigraphy (SRS) showing two small foci of moderately intense abnormal radiotracer uptake within the gastrinoma triangle.
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fig2
She subsequently had a SRS scan performed, which revealed two small lesions within the gastrinoma triangle (Figure 2).
Pathology of pancreatic neuroendocrine tumor with positive staining for gastrin.
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Pathology of the pancreas returned positive for four microscopic foci (the largest being 0.1 cm) of a well-differentiated neuroendocrine tumor with metastasis to two peripancreatic lymph nodes (Figure 3).