Duodenum Brunner Bezi Ezilme Artefaktının Görülme Sıklığı: Retrospektif Bir Çalışma

Year 2021, Volume: 5 Issue: 3, 171 - 175, 22.12.2021

Murat Çelik

https://doi.org/10.46332/aemj.737702

Abstract

Amaç: Bu çalışmanın amacı, az bilinen bir antite olan Brunner bezi ezilme artefaktının şiddeti ile yaş, cinsiyet ve patolojik tanı gibi hasta özellikleri arasındaki ilişkiyi araştırmaktır.
Araçlar ve Yöntem: Ocak 2019 - Ocak 2020 tarihleri arasında Selçuk Üniversitesi Tıp Fakültesi patoloji laboratuvarına gelen 128 hastaya ait duodenum endoskopik biyopsileri retrospektif olarak incelendi. Biyopsi materyallerinden Hematoksilen-eozin ve histokimyasal PAS boyalarına sahip hasta lamları veri kaynağı olarak kullanıldı. Hastalar ezilme artefaktının şiddeti ve lokalizasyonuna göre
birkaç sınıfa ayrıldı. Kategorik değişkenlerin karşılaştırılmasında ki-kare testi kullanıldı.
Bulgular: Toplam 91 (%71) olguda ezilme artefaktı izlenmiştir. Ezilme artefaktının miktarına gore sınıflandırma sonuçları, 91 olgudan 64 (%50) olgunun hafif, 20 (%16) olgunun orta ve 7 (%5) olgunun şiddetli olduğunu göstermektedir. Ayrıca 28 (%21) olgu mukozada, 14 (%11) olgu submukozada ve 15 (%12) olgu dış alanda lokalizedir. Ezilme artefaktı ile yaş, cinsiyet ve patolojik tanı arasında
istatistiksel olarak anlamlı ilişki bulunamamıştır.
Sonuç: Brunner bezi ezilme artefaktı, patolojik bir bulgu olmamasına rağmen neoplazmlar ve enfeksiyöz hastalıklar gibi çeşitli hastalıklar ile morfolojik olarak karışıklığa neden olabilmektedir. Çalışma, gereksiz prosedürleri ve daha da önemlisi yanlış tanıyı ve gereksiz tedaviyi önlemek için Brunner bezi ezilme artefaktına ilişkin değerli bilgiler sağlamaktadır.

Keywords

Duodenum, Brunner Bezleri, Artefaktlar, Endoskopi

Prevalence of Duodenum Brunner Gland Crush Artifact: A Retrospective Study

Abstract

Purpose: The overall purpose of this study is to raise the awareness of the Bruner gland crush artifact, which is a less known entity. Specifically, this study investigates the relationship between the severity of crush artifact and patient characteristics such as age, gender, and pathological diagnosis.
Materials and Methods: Duodenum endoscopic biopsies of patients who presented to the pathology laboratory of the Selcuk University Medical Faculty between January 2019 and January 2020 were retrospectively examined. The data source is patients' slides possessing Hematoxylin-eosin and histochemical PAS stains from biopsy materials. The patients are grouped into several classes according to the crush artifact's severity and location. Chi-square was used in the comparison of categorical variables.
Results: Crushing artifacts were found in 91 (71%) patients. Classification results show that out of 91 (71%) cases, 64 cases (50%) are mild, 20 cases (16%) are moderate, and 7 cases (5%) are severe according to the amount of crush artifact. Also, 28 cases (21%) are located in the mucosa, 14 cases (11%) in the submucosa, and 15 cases (12%) are in the outer area. There was no statistically
significant relationship between the amount of crush artifact and age, gender, and pathological diagnosis.
Conclusion: Although it is not a pathological finding, Brunner gland crush artifact can be morphologically confused with various diseases such as neoplasms and infectious diseases. The study provides valuable insight regarding the Brunner gland crush artifact to prevent unnecessary procedures and, more importantly, misdiagnosis and unnecessary treatment.

Keywords

Duodenum, Brunner Glands, Artifacts, Endoscopy

References

• 1. Chatterjee S. Artifacts in histopathology. J Oral Maxillofac Pathol. 2014;18(1):111-116.
• 2. Taqi SA, Sami SA, Sami LB, Zaki SA. A review of artifacts in histopathology. J Oral Maxillofac Pathol. 2018;22(2):279.
• 3. Goutal-Landry CM, Mansell J, Ryan KA, Gaschen FP. Effect of endoscopic forceps on quality of duodenal mucosal biopsy in healthy dogs. J Vet Intern Med. 2013;27(3):456-461.
• 4. Wu ML, Natarajan S, Lewin KJ. Peculiar artifacts mimicking carcinoma. Arch Pathol Lab Med. 2001;125(11):1473-1476.
• 5. Gonzalez RS. A brief examination of "Brunner Gland Paste". Int J Surg Pathol. 2017;25(3):287-288.
• 6. Odze RD, Goldblum JR. Surgical pathology of the GI tract, liver, biliary tract and pancreas. 3. ed. Philadelphia, PA:Saunders;2014.
• 7. Zhang L, Chandan VS, Wu TT. Surgical pathology of nonneoplastic gastrointestinal diseases. Switzerland:Springer;2019.
• 8. Serra S, Jani PA. An approach to duodenal biopsies. J Clin Pathol. 2006;59(11):1133-1150.
• 9. Owen DR, Owen DA. Celiac disease and other causes of Duodenitis. Arch Pathol Lab Med. 2018;142(1):35-43.
• 10. Montgomery EA, Voltaggio L. Biopsy interpretation of the gastrointestinal tract mucosa. 2. ed. Philadelphia, PA: Lippincott Williams & Wilkins;2011.
• 11. Arnold CA, Moreira RK, Lam-Himlin D, De Petris G, Montgomery E. Whipple disease a century after the initial description: increased recognition of unusual presentations, autoimmune comorbidities, and therapy effects. Am J Surg Pathol. 2012;36(7):1066-1073.
• 12. Dray X, Vahedi K, Delcey V, et al. Mycobacterium avium duodenal infection mimicking Whipple's disease in a patient with AIDS. Endoscopy. 2007;39(1):296-297.
• 13. Onoda N, Kobayashi H, Satake K, et al. Granular cell tumor of the duodenum: a case report. Am J Gastroenterol. 1998;93(10):1993-1994.
• 14. Woosley JT, Grimm I. Granular-cell tumor of the duodenum: a case report. Gastrointest Endosc. 2006;63(2):339-341.
• 15. Suriawinata AA. Neoplastic Mimics in Gastrointestinal and Liver Pathology. United States: Demos Medical Publishing;2014.
• 16. Gabhane SK, Kotwal MN, Bobhate SK. Morphological spectrum of peripheral nerve sheath tumors: A series of 126 cases. Indian J Pathol Microbiol. 2009;52(1):29–33.
• 17. Chikkannaiah P, Boovalli MM, Nathiyal V, Venkataramappa S. Morphological spectrum of peripheral nerve sheath tumors: An insight into World Health Organization 2013 classification. J Neurosci Rural Pract. 2016;7(3):346-354.