Endoscopic findings and pathological characteristics of duodenal protuberant lesions / 中华消化杂志

ABSTRACT

Objective To explore endoscopic findings and histopathological characteristics of duodenal protuberant lesions in order to improve diagnosis of duodenal protuberant lesions.Methods A total of 869 cases of duodenal protuberant lesions were detected and collected in endoscopy center of Drum Tower Hospital from 2005 to 2010,of which endoscopy findings and pathological characteristics were studied retrospectively.Results Of the 869 case with duodenal protuberance,50 cases were misdiagnosed as real protuberant lesions.Of the 819 real protuberant lesions,781 cases (95.4％)were benign lesions and 38 cases (4.6％) were malignant lesions.Pathological results indicated that most were chronic inflammation benign lesions (338 cases),accounted for 41.3％.Secondary were Brunner gland hyperplasia (155 cases),accounted for 18.9％.Of malignant lesions,most were adenocarcinoma (25 cases,accounting for 3％ ),others were six cases of carcinoid tumor,six cases of malignant lymphoma and one case of embryonal rhabdomyosarcoma.Endoscopic findings of duodenal protuberant lesions were diverse,such as round,hemispheric,finger-like,lobulated,streak and so on.The diameter of duodenal protuberant lesions varied,the largest was 5 centimeter and most were sessile lesions (726 cases,88.6％).Endoscopic ultrasonic findings indicated that internal echo of benign lesions were even and each layer of structure was clear,while malignant lesions presented uneven internal echo,unclear layer structure and adjacent tissue or lymphoma nodes invasion.Conclusions Duodenal protuberant lesions cannot be confirmed by conventional endoscopic findings.Endoscopic ultrasonography may help to improve the diagnosis.Diagnosis should be confirmed by pathology.