Differential Diagnosis of Polypoid Lesions in the Duodenal Bulb Based on Radiologic and Endoscopic Findings Kenji Kawamoto 1 , Toshihiko Ueyama 1 , Akinori Iwashita 2 1Department of Radiology, Faculty of Medicine, Kyushu University 2Department of pathology, Fukuoka University Chikushi Hospital Keyword: 十二指腸球部隆起性病変 , 形態分類 , 異所性胃粘膜 , 鑑別診断 pp.651-669
Published Date 1993/6/25
DOI https://doi.org/10.11477/mf.1403106188
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 Five thousand three hundred thirty five patients underwent upper gastrointestinal endoscopic examination with biopsy. One hundred forty three patients with duodenal polypoid lesion (DPL) in the bulb (2.7% for all cases) were evaluated for the prevalence of each morphological featues. Non-specific polypoid lesion (NSPL) were the most common type, followed by heterotopic gastric mucosa (HGM). One hundred twenty six patients with DPL in the bulb, who underwent both radiologic and endoscopic examinations, were evaluated for their morphological characteristics using our classification. DPL could be classified into seven types (Types A-G), as shown in Fig.2. In 35 multiple lessions (Types A-C), one patient had malignant lymphoma, but the rest had benign diseases (97%). Eighty two (90%) out of 91 single lesions (Types D-G) were benign and nine (10%) were malignant. The salient points in the differentiation between benign and maliganant diseases were the existence of erosion or hemorrhage of the mucosa, and marginal irregularity and rapid enlargement of a central depression.

 In conclusion, the existence of morphological variability of HGM is especially important to remember for the differential diagnosis of DPL. Our new, comprehensive classification of DPL, based on radiologic and endoscopic examinations, will contribute to the differentiation between malignant and begnign diseases.

Copyright © 1993, Igaku-Shoin Ltd. All rights reserved.


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