Abstract
From 1975 to 1986, we have experienced 11 cases of duodenal adenoma among 79 cases of benign elevated lesion of duodenum (Table 1). We analized clinicopathologically these cases with adenoma and the following results were obtained. 1) Male-female ratio was 8: 3 and average age was 55.4 years. All eleven cases localized in 1st and IInd portion of proximal duodenum. Macroscopically, 8 cases showed non-sessile elevated lesions (Table 2). 2) These adenomas showed various histological atypia (Table 3, 4). One small tubulo-villous adenoma showed high grade atypia and immunohistochemical CEA. CA19-9 localization were positive in adenoma. These histological and immunohistochemical findings suggested that this small lesion was pre-malignant (Figure 4-b, c, d). 3) Endoscopically, cases of low grade atypia showed smooth, whitish and wellglistened surface (Figure 2-a, b). Cases of high grade atypia showed granular, red and ill-glistened surface (Figure 4-a, b). 4) Small duodenal adenoma (0.7 cm in size) of 24 years old male which was associated with Familial Adenomatosis Coli showed moderate atypia and slightly positive localization of CEA. CA19-9, and suggested malignant potentiality. 5) Histologically all of adenomas uncle 3 cm in diameter were tubular adenoma and the large adenomas over 3 cm were tubulo-villous adenomas. Duodenal adenoma may be initiate with tubular pattern in early stage and composite with villous pattern as it develope to large tumors. 6) We suspected as two types in duodenal adenomas that one was remained in adenoma but another type adenoma showed increasing atypia and finally transformed to adenocarcinoma as it developed.
