Endoscopic features of the duodenal pyloric gland adenoma: A case series of 14 patients

Abstract Background Pyloric gland adenoma (PGA) is a distinct subtype of duodenal adenoma. PGA has been increasingly recognized as a histologically and molecularly distinct entity; however, its endoscopic features have not been precisely described. This study aims to investigate the endoscopic chara...

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Main Authors: Takeshi Uozumi, Satoru Nonaka, Yasuhiko Mizuguchi, Haruhisa Suzuki, Seiichiro Abe, Shigetaka Yoshinaga, Shigeki Sekine, Yutaka Saito
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:DEN Open
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Online Access:https://doi.org/10.1002/deo2.70038
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author Takeshi Uozumi
Satoru Nonaka
Yasuhiko Mizuguchi
Haruhisa Suzuki
Seiichiro Abe
Shigetaka Yoshinaga
Shigeki Sekine
Yutaka Saito
author_facet Takeshi Uozumi
Satoru Nonaka
Yasuhiko Mizuguchi
Haruhisa Suzuki
Seiichiro Abe
Shigetaka Yoshinaga
Shigeki Sekine
Yutaka Saito
author_sort Takeshi Uozumi
collection DOAJ
description Abstract Background Pyloric gland adenoma (PGA) is a distinct subtype of duodenal adenoma. PGA has been increasingly recognized as a histologically and molecularly distinct entity; however, its endoscopic features have not been precisely described. This study aims to investigate the endoscopic characteristics of duodenal PGA, including the association of their putative precursors, Brunner's gland hyperplasia (BGH), and gastric epithelial heterotopia/metaplasia (GEM/H). Methods This study was a single‐center, retrospective case series. Fourteen consecutive patients with duodenal PGA were retrieved from the pathological database. PGA was diagnosed according to the World Health Organization classification. Results The median tumor size was 22.5 mm (range: 12–40 mm), and 79% of cases were located in the first part of the duodenum. Six PGAs demonstrated high‐grade dysplasia. PGA could be classified into two subtypes based on their appearance: villous lobulated type and smoothly protruding type. BGH and GEM/H were identified in the background mucosa in 28% and 7% of the cases, respectively. BGH was more abundant in the background mucosa of the PGA group than in the control group (p < 0.05). Six PGAs (43%) exhibited high‐grade dysplasia, and no significant difference was observed in the endoscopic findings between low‐ and high‐grade dysplasia. Conclusions The 14 patients with PGA demonstrated characteristic endoscopic findings. BGH and GEM/H might be precursors of PGA.
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spelling doaj-art-c276adf4218d4feaaac3dcc0f4f45eaf2025-08-20T03:13:36ZengWileyDEN Open2692-46092025-04-0151n/an/a10.1002/deo2.70038Endoscopic features of the duodenal pyloric gland adenoma: A case series of 14 patientsTakeshi Uozumi0Satoru Nonaka1Yasuhiko Mizuguchi2Haruhisa Suzuki3Seiichiro Abe4Shigetaka Yoshinaga5Shigeki Sekine6Yutaka Saito7Endoscopy Division National Cancer Center Hospital Tokyo JapanEndoscopy Division National Cancer Center Hospital Tokyo JapanEndoscopy Division National Cancer Center Hospital Tokyo JapanEndoscopy Division National Cancer Center Hospital Tokyo JapanEndoscopy Division National Cancer Center Hospital Tokyo JapanEndoscopy Division National Cancer Center Hospital Tokyo JapanDivision of Diagnostic Pathology National Cancer Center Hospital Tokyo JapanEndoscopy Division National Cancer Center Hospital Tokyo JapanAbstract Background Pyloric gland adenoma (PGA) is a distinct subtype of duodenal adenoma. PGA has been increasingly recognized as a histologically and molecularly distinct entity; however, its endoscopic features have not been precisely described. This study aims to investigate the endoscopic characteristics of duodenal PGA, including the association of their putative precursors, Brunner's gland hyperplasia (BGH), and gastric epithelial heterotopia/metaplasia (GEM/H). Methods This study was a single‐center, retrospective case series. Fourteen consecutive patients with duodenal PGA were retrieved from the pathological database. PGA was diagnosed according to the World Health Organization classification. Results The median tumor size was 22.5 mm (range: 12–40 mm), and 79% of cases were located in the first part of the duodenum. Six PGAs demonstrated high‐grade dysplasia. PGA could be classified into two subtypes based on their appearance: villous lobulated type and smoothly protruding type. BGH and GEM/H were identified in the background mucosa in 28% and 7% of the cases, respectively. BGH was more abundant in the background mucosa of the PGA group than in the control group (p < 0.05). Six PGAs (43%) exhibited high‐grade dysplasia, and no significant difference was observed in the endoscopic findings between low‐ and high‐grade dysplasia. Conclusions The 14 patients with PGA demonstrated characteristic endoscopic findings. BGH and GEM/H might be precursors of PGA.https://doi.org/10.1002/deo2.70038Brunner's gland hyperplasiaduodenumgastric epithelial metaplasiapyloric gland adenomawhite opaque substance
spellingShingle Takeshi Uozumi
Satoru Nonaka
Yasuhiko Mizuguchi
Haruhisa Suzuki
Seiichiro Abe
Shigetaka Yoshinaga
Shigeki Sekine
Yutaka Saito
Endoscopic features of the duodenal pyloric gland adenoma: A case series of 14 patients
DEN Open
Brunner's gland hyperplasia
duodenum
gastric epithelial metaplasia
pyloric gland adenoma
white opaque substance
title Endoscopic features of the duodenal pyloric gland adenoma: A case series of 14 patients
title_full Endoscopic features of the duodenal pyloric gland adenoma: A case series of 14 patients
title_fullStr Endoscopic features of the duodenal pyloric gland adenoma: A case series of 14 patients
title_full_unstemmed Endoscopic features of the duodenal pyloric gland adenoma: A case series of 14 patients
title_short Endoscopic features of the duodenal pyloric gland adenoma: A case series of 14 patients
title_sort endoscopic features of the duodenal pyloric gland adenoma a case series of 14 patients
topic Brunner's gland hyperplasia
duodenum
gastric epithelial metaplasia
pyloric gland adenoma
white opaque substance
url https://doi.org/10.1002/deo2.70038
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