He was taken to the operating room and was found to have a 3 cm, ulcerated, submucosal lesion just beyond the ampulla of Vater. He subsequently underwent a segmental resection of the third portion of the duodenum, with end-to-side duodenoduodenostomy. Surgical pathology revealed that the tumour was a Brunner’s gland hamartoma arising from the submucosal layer of the third portion of the duodenum (Figure 4). Two months after surgical resection, the patient was seen during follow-up, at which time, his hemoglobin concentration was normal, at 152 g/L, suggesting that this lesion was the source of his previous iron-defi-ciency anemia. Best quality drugs are something you have been looking for all this time? Then you will be happy to find out you can purchase birth control pills easily and for very little money now that you have the best pharmacy at your service.
Figure 4) Top Surgical pathology specimen showing the architecture of the Brunner’s gland hamartoma (original magnification x50). This slide shows multiple lobules of glands and ducts that retain the appearance of those normally found in Brunner’s glands. Bottom High power view (original magnification x400) of a lobule contained within the Brunner’s gland hamartoma. This slide shows acini lined by normal appearing ductal cells. Note that the cytoplasm has a foamy appearance and that the nuclei are flattened along the periphery of the cell – an effect that is due to crowding within the lobules