A CASE OF BRUNNER'S GLAND HYPERPLASIA IN THE DUODENAL BULB

A case of Brunner's gland hyperplasia in the duodenum presenting as a duodenal submucosal tumor was experienced. A 36-year-old male patient with no symptoms was found abnormality in the duodenum by mass screening examination. X-ray and endoscopic examinations of upper gastrointestial tract revealed a submucosal tumor in the duodeal bulb. The specimen of biopsy could not reveal histology of the tumor. Therefore, endoscopic ultrasonography (EUS), computed tomography, and magnetic resonance imaging were carried out. EUS visualized a homogenous and slight high echoic tumor originating from the submucosal layer, and Brunner's gland hyperplasia was strongly suspected. A possibility of malignant tumor, however, could not be excluded, and distal partial gastrectomy was performed. The excised tumor was 30×20×20 mm in size. Histrogical examination revealed nodular hyperplasia of the Brunner's gland and it was diagnosed as Brunner's gland hyperplasia in the duodenum.EUS was useful for the diagnosis of the Brunner's gland hyperplasia, in which biopsy failed to make a definite diagnosis.