Endoscopic ultrasound of duodenal heterotopic gastric mucosa

OBJECTIVE: Recent studies have reported that duodenal heterotopic gastric mucosa (HGM) has been observed in 8.9% of patients who undergo esophagogastroduodenoscopy. However, there are few reports concerning the endoscopic and endoscopic ultrasound characteristics of submucosal tumour-like HGM in the duodenum.METHODS: Endoscopic, endoscopic ultrasound (EUS) and histological findings were analyzed in six patients with submucosal tumour-like HGM, which were confirmed by pathological examination of biopsy or endoscopic polypectomy specimens.RESULTS: Endoscopically, the lesions appeared as a solitary, sessile submucosal tumour-like mass with a depression at the top. In four of six patients, small granular structures were found in the depressed area of the mass. On EUS, all masses demonstrated a heterogeneous pattern, among which four patients presented anechoic areas while two patients showed no anechoic areas. All lesions were localized within the mucosa and submucosa on EUS. Histologically, they consisted of gastric glands and some dilated glands, and were covered with normal duodenal epithelium. In four of six lesions, the tumours were composed of gastric-type foveolar epithelium showing papillary growth, fundic glands and pyloric glands, while the others consisted of gastric-type foveolar epithelium and pyloric glands.CONCLUSION: A heterogeneous pattern on EUS and small granular structures on esophagogastroduodenoscopy represent valuable diagnostic features of submucosal tumour-like HGM.

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Faculty Opinions recommendation of Argon plasma coagulation of cervical heterotopic gastric mucosa as an alternative treatment for globus sensations.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1165580.628593 ◽

2009 ◽

Author(s):

John Pandolfino

Keyword(s):

Gastric Mucosa ◽

Alternative Treatment ◽

Argon Plasma Coagulation ◽

Argon Plasma ◽

Heterotopic Gastric Mucosa ◽

Plasma Coagulation

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Symptomatic Heterotopic Gastric Mucosa in Distal Esophagus

Journal of Health and Allied Sciences NU ◽

10.1055/s-0041-1731141 ◽

2021 ◽

Author(s):

Avnish Kumar Seth ◽

Mahesh Kumar Gupta ◽

Gursimran Kaur ◽

Priti Jain ◽

Rinkesh Kumar Bansal

Keyword(s):

Gastric Mucosa ◽

Squamous Epithelium ◽

Narrow Band Imaging ◽

Distal Esophagus ◽

Heterotopic Gastric Mucosa ◽

Retrosternal Pain ◽

Gastric Type ◽

History Of ◽

Mass Lesions

Abstract Introduction Heterotopic gastric mucosa (HGM) in esophagus is commonly noted as an inlet patch at endoscopy. We describe a rare patient with symptomatic distal esophageal HGM. Case Report A 40-year-old male presented with retrosternal pain and marked odynophagia for the last 4 weeks without any history of ingestion of antibiotics, foreign body, or corrosive. Endoscopy showed abrupt circumferential transition to salmon pink mucosa at 35 cm from incisors. From 35 to 41 cm, there were areas of polypoid edematous thickening with few superficial ulcers of 1 to 3 mm. Squamous epithelium was visualized at narrow band imaging from 41 cm to the Z-line at 43 cm with no hiatus hernia. Biopsy showed gastric-type mucosa with parietal cells without dysplasia. Serology for cytomegalovirus and human immunodeficiency virus was negative. He was managed with proton pump inhibitors (PPIs) and prokinetics and improved symptomatically. Follow-up endoscopy at 3 months demonstrated healing of ulcers with persistence of HGM and pseudopolyps. He remains well on maintenance with PPI at 1-year follow-up. Conclusion Symptomatic HGM in distal esophagus is rare and can be differentiated from Barrett’s esophagus histologically and by presence of squamous epithelium between HGM and stomach. Inflammatory mass lesions may develop and mimic esophageal malignancy. Symptoms are largely due to acid production and usually respond to PPI.

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Heterotopic gastric mucosa in the gallbladder—a rare find

Journal of Surgical Case Reports ◽

10.1093/jscr/rjaa490 ◽

2020 ◽

Vol 2020 (12) ◽

Author(s):

Roberto Cunha ◽

Rafaela Parreira ◽

Rui Quintanilha ◽

Vítor Carneiro ◽

Armando Medeiros ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

Gastrointestinal Tract ◽

Gastric Mucosa ◽

Histological Change ◽

Heterotopic Gastric Mucosa ◽

Gallbladder Polyp ◽

Usual Location ◽

Common Situation

Abstract It is universally known and accepted that the development of a certain type of tissue outside its usual location, like in the gastrointestinal tract, can occur. This is a relatively common situation in the upper region of the gastrointestinal tract. However, the development of gastric mucosa in the gallbladder is a rare find. The following is the case of a 22-year-old male with an 18 mm gallbladder polyp, who electively underwent a laparoscopic cholecystectomy, having been diagnosed at a histopathological level with heterotopic gastric mucosa in the gallbladder. This brief article also aims to provide a reflection on the possible evolution of neoplasms from this histological change, based on the doubts raised in literature.

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Rare presentation of annular and polypoid heterotopic gastric mucosa in duodenum

JGH Open ◽

10.1002/jgh3.12434 ◽

2020 ◽

Author(s):

Takayoshi Kiba ◽

Naoki Kotoh ◽

Masahiro Tsuboi

Keyword(s):

Gastric Mucosa ◽

Heterotopic Gastric Mucosa ◽

Rare Presentation

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Heterotopic gastric mucosa in the hilar bile duct mimicking hilar cholangiocarcinoma: report of a case

Surgery Today ◽

10.1007/s00595-012-0221-x ◽

2012 ◽

Vol 43 (1) ◽

pp. 91-95 ◽

Cited By ~ 12

Author(s):

Saburo Fukuda ◽

Syoichiro Mukai ◽

Seiichi Shimizu ◽

Masatoshi Kouchi ◽

Seiji Fujisaki ◽

...

Keyword(s):

Bile Duct ◽

Gastric Mucosa ◽

Hilar Cholangiocarcinoma ◽

Heterotopic Gastric Mucosa ◽

Hilar Bile Duct

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Prevalencia de mucosa gástrica heterotópica cervical y su relación con síntomas de reflujo gastroesofágico. Estudio observacional

Acta gastroenterológica latinoamericana ◽

10.52787/oqgh3367 ◽

2021 ◽

Vol 51 (2) ◽

Author(s):

Natalia Marina Zeytuntsian ◽

José Tawil ◽

Ana Adet Caldelari ◽

Álvaro Falzone ◽

Patricio Sheridan ◽

...

Keyword(s):

Gastric Mucosa ◽

Clinical Manifestations ◽

Heterotopic Gastric Mucosa ◽

Extraesophageal Reflux ◽

Cross Sectional ◽

Reflux Symptoms ◽

Throat Clearing ◽

Extraesophageal Symptoms ◽

The Mean ◽

Upper Gastrointestinal

Introduction. The heterotopic gastric mucosal patch or inlet patch is the presence of gastric columnar mucosa outside the stomach, most frequently located in the proximal esophagus. Its manifestations vary from esophageal and extraesophageal reflux symptoms to major complications, most of them being asymptomatic. Aim. To determine the prevalence of cervical heterotopic gastric mucosa in our environment and its association with esophageal and extraesophageal reflux symptoms. Material and methods. Prospective cross-sectional and observational study; consecutive patients who came to our institution between December 2018 and October 2019 for diagnostic upper gastrointestinal videoendoscopy were included, following a questionnaire on clinical manifestations. Results. A total of 1,408 patients were included. In 89 (6.3%), a cervical heterotopic gastric mucosal patch was described. The mean age of the patients without this condition was 54.6 and 55.5 in patients with it. The esophageal symptoms of gastroesophageal reflux (heartburn, regurgitation, and chest pain) in patients with cervical heterotopic gastric mucosa was observed in 40 (44.9% / p = 0.473), 12 (13.5% / p = 0.783) and 4 (4.5% / p = 0.199) patients respectively. The presence of extraesophageal symptoms (globus, chronic cough, dysphonia, and throat clearing) in patients with cervical heterotopic gastric mucosa was: 9 (10.1% / p = 0.011); 7 (7.9% / p = 0.155); 4 (4.5% / p = 0.458) and 9 (10.1% / p = 0.036) respectively. Conclusions. A statistically significant association was found between the presence of cervical heterotopic gastric mucosal patch and symptoms of globus (p = 0.011) and throat clearing (p = 0.036). It could be interpreted that this group of patients would benefit from the research and treatment of this condition with the intention of improving their symptoms.

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