PMC6008950_01
PGA located in the second portion of the duodenum opposite to the ampulla.
CRIGM2018-9287843.001.jpg
PMC6008950_01_CRIGM2018-9287843.001.jpg
fig1
Several weeks later he underwent an endoscopic ultrasound that revealed a 13-mm pedunculated and sessile polyp on the lateral wall opposite to the major papilla in the second portion of the duodenum (Figure 1).
Low power view of the PGA (arrow) arising from the duodenum with normal villous mucosa (arrowhead).
CRIGM2018-9287843.002.jpg
PMC6008950_01_CRIGM2018-9287843.002.jpg
fig2
Pathology revealed a pyloric gland adenoma (Figures 2, 3, and 4) with predominantly low grade dysplasia (Figures 5 and 6) and some small areas of focal high grade dysplasia.
High power view of the PGA (arrow) arising from the duodenum with normal villous mucosa (arrowhead).
CRIGM2018-9287843.003.jpg
PMC6008950_01_CRIGM2018-9287843.003.jpg
fig3
Pathology revealed a pyloric gland adenoma (Figures 2, 3, and 4) with predominantly low grade dysplasia (Figures 5 and 6) and some small areas of focal high grade dysplasia.
High power view of the PGA showing the ground glass appearance of cytoplasm and a monolayer of round nuclei.
CRIGM2018-9287843.004.jpg
PMC6008950_01_CRIGM2018-9287843.004.jpg
fig4
Pathology revealed a pyloric gland adenoma (Figures 2, 3, and 4) with predominantly low grade dysplasia (Figures 5 and 6) and some small areas of focal high grade dysplasia.
High power view exhibiting small amount of atypia of the PGA.
CRIGM2018-9287843.005.jpg
PMC6008950_01_CRIGM2018-9287843.005.jpg
fig5
Pathology revealed a pyloric gland adenoma (Figures 2, 3, and 4) with predominantly low grade dysplasia (Figures 5 and 6) and some small areas of focal high grade dysplasia.
High power view exhibiting cell atypia including nuclear membrane irregularity and nuclear pleomorphism.
CRIGM2018-9287843.006.jpg
PMC6008950_01_CRIGM2018-9287843.006.jpg
fig6
Pathology revealed a pyloric gland adenoma (Figures 2, 3, and 4) with predominantly low grade dysplasia (Figures 5 and 6) and some small areas of focal high grade dysplasia.