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Brunner's gland hamartoma: computed tomographic findings with histopathologic correlation in 9 cases
Saebeom Hur1, Joon Koo Han, Min-A Kim
1Department of Radiology, Seoul National University College of Medicine, Seoul, Korea.
Insights
Computed tomographic (CT) imaging can identify Brunner's gland hamartomas, which appear as small duodenal polyps. Key CT findings include hypoattenuation and peripheral rimlike enhancement, aiding diagnosis.
Area of Science:
- Radiology
- Gastroenterology
- Pathology
Background:
- Brunner's gland hamartomas are benign duodenal tumors.
- Accurate diagnosis relies on understanding their imaging characteristics.
Purpose of the Study:
- To detail the computed tomographic (CT) features of Brunner's gland hamartomas.
- To correlate CT findings with histopathologic results.
Main Methods:
- Retrospective review of CT scans from 9 patients with pathologically confirmed Brunner's gland hamartoma.
- Utilized multidetector-row CT scanners with portal venous phase imaging.
Main Results:
- Brunner's gland hamartomas appeared as small polyps (mean 1.9 cm), often Yamada type II or III.
- Common findings included internal cysts (33%) and hypoattenuation on portal phase CT (56%).
- Peripheral rimlike enhancement (67%) was frequent, with homogeneous enhancement in later phases.
Conclusions:
- Asymptomatic, small submucosal duodenal masses exhibiting hypoattenuation and peripheral rimlike enhancement suggest Brunner's gland hamartoma.
- CT features, particularly hypoattenuation and rim enhancement, are crucial for suspecting this diagnosis.
Objective:
To describe the computed tomographic (CT) features of Brunner's gland hamartoma with histopathologic correlation.
Methods:
The CT images of 9 patients with pathologically proven Brunner's gland hamartoma were reviewed retrospectively. All patients underwent CT performed on multidetector-row CT scanner with various protocols, all of which included portal venous phase.
Results:
Brunner's gland hamartomas presented as small (mean, 1.9 cm) Yamada type II or III (67%, 6/9) polyps with frequent internal cyst (33%, 3/9). They were isoattenuated on unenhanced CT (83%, 5/6) and hypoattenuated in portal phase (56%, 5/9) when compared with the pancreas. Peripheral rimlike enhancement in earlier phase was commonly found (67%, 6/9) and most of them enhanced homogeneously in the later phase (100%, 4/4).
Conclusions:
In a patient with asymptomatic small submucosal mass in the duodenal first or second portion, hypoattenuated mass with peripheral rimlike enhancement or internal cystic change suggests the possibility of Brunner's gland hamartoma.
