ABSTRACT
Brunner's gland hamartomas are rare, benign duodenal tumors. But, they are the commonest hamartomas in the small intestine and believed to represent hyperplasia of Brunner's glands, perhaps in response to excessive gastric acid secretion. Brunner's gland hamartomas are usually smaller than 1cm and asymptomatic, incidental finding during endoscopy or radiographic examination. We report a case of large Brunner's gland hamartoma which prolapsed into gastric antrum and caused gastric outlet obstruction, and was resected by endoscopic polypectomy.
Subject(s)
Brunner Glands , Endoscopy , Gastric Acid , Gastric Outlet Obstruction , Hamartoma , Hyperplasia , Incidental Findings , Intestine, Small , Pyloric AntrumABSTRACT
BACKGROUND: The cell mediated immunity has an important role in the pathogenesis of tuberculosis. sIL-2R has been known as a sensitive marker of T lymphocyte activation. Elevated serum levels of sIL-2R have been found in patients with lymphoproliferative disorders, organ transplantation, autoimmune diseases, and various granulomatous diseases. Elevated levels of sIL-2R have been also found in the seam and pleural fluid of the patients with tuberculosis. To evaluate the diagnostic value of sIL-2R in the differentiation of tuberculous pleurisy and. nontuberculous pleurisy. We measured the level of sIL-2R in the sera and pleural fluids of 12 patients with tuberculous pleurisy and 32 patients with nontuberculous pleurisy. METHOD: Samples of pleural fluid and serum were centrifuged at 2500 rpm for 10 min to remove cell pellets. Soluble R-2R was measured with a sandwitch enzyme immunoassay using the Cellfree r Interleukin-2 Receptor Test kit( T-cell science, Inc. Cambridge, MA). RESULTS: The results obtained were as follows: 1) The sIL-2R level in pleural fluid of the patients with tuberculous pleurisy was higher than that of patients with nontuberculous pleurisy(P0.05). 4) In patients with tuberculous pleurisy, the mean concentration of sIL-2R in pleural fluid was higher than that in serum(P<0.005). CONCLUSION: These findings suggest that the measurement of elevated levels of pleural fluid sIL-2R in tuberculous pleurisy may be useful in the differential diagnosis between patients with tuberculous pleurisy and nontuberculous pleurisy.