Hyperplasia of Brunner glands: the spectrum of its radiographic manifestations

Radiographic features of the duodenal mucosa were analyzed in a series of 26 patients in whom the diagnosis of Brunner gland hyperplasis (BGH) had been established by endoscopic biopsies. The observed mucosal patterns could be classified into five categories: (1) focal BGH causing a solitary submucosal adenoma or a cluster of sessile polyps in the otherwise smooth duodenal bulb surface (five cases); (2) diffuse BGH manifested by a myriad of small and uniform mucosal elevations (six cases); (3) multifocal BGH producing large and well-demarcated polygonal masses (six cases); (4) BGH with concomitant acute and/or chronic duodenitis showing marked thickening and nodularity of duodenal folds (four cases); or (5) BGH with predominant erosive duodenitis, leading to ulcerations (five cases). These radiographic findings showed a good correlation with the endoscopic and histopathologic manifestations of BGH and the frequently coexistent duodenitis.