md-medicaldata

Authors

 

Bojana Andrejić Višnjić ¹, Matilda Đolai^1,2, Sandra Trivunić Dajko^2,3, Aleksandra Lovrenski^3,4, Svetlana Balj Barbir<sup>5

1</sup>Univerzitet u Novom Sadu, Medicinski Fakultet, Katedra za histologiju i embriologiju.
²Centar za patologiju i histologiju, Klinički centar Vojvodine, Novi Sad, Srbija
³Univerzitet u Novom Sadu, Medicinski fakultet, Katedra za patologiju.
⁴Služba za patoanatomsku i molekularnu dijagnostiku, Institut za plućne bolesti Vojvodine, Sremska Kamenica, Srbija.
⁵Institut za zaštitu zdravlja dece i omladine Vojvodine, Novi Sad, Srbija.

 

UDK: 616.342

The paper was received / Rad primljen: 06.12.2018.

Accepted / Rad prihvaćen: 16.12.2018

 

Correspondence to:

Doc.dr Bojana Andrejić Višnjić
Univerzitet u Novom Sadu, Medicinski fakultet, Katedra za histologiju i embriologiju
Hajduk Veljkova 3,
21000 Novi Sad, Srbija
tel: +381 63 166-93-00
e-mail: bojana.andrejic-visnjic@mf.uns.ac.rs

 

 

Sažetak

 

Morfologija i morfometrija patološki izmenjenog tankog creva često je predmet istraživanja, dok postoji primetni nedostatak informacija o kvantitativnim karakteristikama zdrave sluznice humanog tankog creva, samim tim i duodenuma. Stoga je cilj našeg ispitivanja bilo utvrđivanje osnovnih morfoloških i morfometrijskih karakteristika sluznice duodenuma, i ispitivanje postojanja uticaja Brunerovih žlezda na strukturu sluznice. U studiju je uključeno 60 bioptičkih uzoraka duodenuma očuvane sluznice, sa minimum 5 uzastopnih i pravilno orijentisanih crevnih resica. Formirane su dve grupe: A - preparati koji ne sadrže Brunerove žlezde u sluznici; B - preparati koji u sluznici sadrže Brunerove žlezde. Korišćenjem kompjuterskog stereološkog programa vršena su merenja debljine sluznice, visine resica, dubine kripti i izračunat je vilokriptalni odnos. U grupi B vršeno je i merenje prečnika lobusa Brunerovih žlezda i brojanje acinusa po vidnom polju. Rezultati: Kod 50% preparata registrovano je prisustvo Brunerovih žlezda u sluznici duodenuma. Uočeno je postojanje razlika u vrednosti svih analiziranih parametara, ali je statistički značajna jedino manja dubna kripti u uzorcima sa prisutnim žlezdama u sluznici. Brunerove žlezde su prosečno zauzimale 28,38% debljine sluznice, sa prosečno 16,01 acinusa po vidnom polju. Brunerovih žlezda su dominantno imale građu tipa razgranatih tubularnih i tubuloalveolarnih žlezda. Konstatovana je i značajna varijacija u obliku resica duodenuma. Naše istraživanje pokazuje da prisustvo Brunerovih žlezda u dubljim delovima sluznice ne bi bilo pravilno smatrati atipičnom pojavom i/ili patološkim nalazom, te da njihovo prisustvo u sluznici ne remeti morfološka i morfometrijska svojstva sluznice, s obzirom da nije utvrđena statistički značajna razlika u karakteristikama sluznice sa i bez Brunerovih žlezda.

 

 

Ključne reči:

duodenum, sluznica, Brunerove žlezde, morfologija, morfometrija

 

 

Abstract

 

Morphology and morphometry of pathologically altered tissue of the small intestine is well known, while there is significant lack of informations about quantitative characteristics of healthy human small intestine mucosa, including duodenal. The aims of this study were to verify basic morphometric features of duodenal mucosa, presence of Brunner’s glands in it, and their influnce on features of the mucosa. Overall 60 bioptic specimens of duodenum were analyzed, all of them having preserved mucosa with a minimum of 5 consecutive and properly oriented villi. Two gruops were formed: A - specimens which do not contain Brunner’s glands in mucosa; B - specimens which contain Brunner’s glands in mucosa. Using a computer program, we measured mucosal thickness, height of villi, depth of crypts and calculated villus to crypt ratio in both groups. Additionally, in group B, diameter of lobules of Brunners glands was measured and number of acini per microscopic field was counted. The presence of Brunner’s glands in duodenal mucosa was registered in 50% of cases. Differences in the analyzed parameters were noted, but only the smaller depth of crypts in group B showed statistical significance. Brunner’s glands occupied 28.38% of the mucosal thickness with average 16.01 of acini per field. Most glands showed structure of branched tubular and tubuloalveolar glands. According to our research, the presence Brunner’s glands in the deeper parts of the mucosa are not an atypical and/or pathological condition, and the presence of the glands does not alter morphological and morphometric features od the duodenal mucosa.

 

 

Key words:

duodenum, mucosa, Brunner’s glands, morphology, morphometry

 

 

References:

 

1. Gartner LP, Hiatt JL. Digestive System: Alimentary Canal. In: Gartner LP, Hiatt JL.  Color Textbook of Histology. 3rd ed. Amsterdam: Saunders; 2006. p. 381-412.
2. Anđelković Z, Somer LJ. Digestivni trakt. In: Anđelković Z, Somer LJ, Avramović V, Milosavljević Z, Tanasković I, Matavulj M, et al. Histologija. 1st ed. Niš: Impressum; 2009. p. 195-223.
3. Junqueira LC, Carniero J. Digestive tract. In: Junqueira LC, Carniero J. Basic Histology: Text & Atlas. 11th ed. New York City: McGraw-Hill Companies; 2005.
4. Giacosa A. Morphometry of normal duodenal mucosa. Scand J Gastroenterol Suppl. 1989;167:10-2.
5. Serra S, Jani PA. An aproach to doudenal biopsies. J Clin Pathol. 2006;59:1133-50.
6. Hasan M, Sircus W, Ferguson A. Duodenal mucosal architecture in non-specific and ulcer-associated duodenitis. Gut. 1981;22:637-41.
7. Trbojević-Stanković JB, Miličević NM, Milošević DP, Despotović N, Davidović M, Erceg P, et al. Morphometric study of healthy jejunal and ileal mucosa in adult and aged subjects. Histol Histopathol. 2010;25:153-8.
8. Gao YP, Zhu JS, Zheng WJ. Brunner’s gland adenoma of duodenum: A case report and literature review. World J Gastroenterol. 2004;10(17):2616-7.
9. Lee WC, Yang HW, Lee YJ, Jung SH, Choi GY, Go H, et al. Brunner’s gland hyperplasia: Treatment of severe diffuse nodular hyperplasia mimicking a malignancy on pancreatic-duodenal area. J Korean Med Sci. 2008;23:540-3.
10. Chattopadhyay P, Kundu A K, Bhattacharyya S, Bandyopadhyay A. Diffuse nodular hyperplasia of Brunner’s gland presenting as upper gastrointestinal haemorrhage. Singapore Med J. 2008;49(1):81.
11. Lawson HH. Definition of gastroduodenal junction in healthy subjects. J Clin Pathol. 1988;41:393-6.
12. Macea MMI, Macea JR, Fregnani TJHG. Quantitative study of Brunner’s glands in the human duodenal submucosa. Int J Morphol. 2006;24(1):7-12.
13. Wilson FD, Cummings TS, Barbosa TM, Williams CJ, Gerard PD, Peebles ED. Comparison of two methods for determination of intestinal villus to crypt ratios and documentation of early age-associated ratio changes in broiler chickens. Poult Sci. 2018; 97(5):1757-1761.
14. Lipski PS, Bennett MK, Kelly PJ, James OFW. Ageing and duodenal morphometry. J Clin Pathol. 1992; 45:450-452.
15. Ettarh RR, Carr KE. Morphometric analysis of the small intestinal epithelium in the indomethacin-treated mouse. J Anat. 1996; 189:51-56.
16. Hol JW, Stuifbergen WNHM, Teepen JLJM, van Laarhoven CJHM. Giant Brunner’s hamartomas of the duodenum and obstructive jaundice: An overview of the literature and suspicion of malignancy in a case. Dig Surg. 2007;24:452-5.

PDF Andrejić Višnjić B. et al • MD-Medical Data 2018;10(4): 179-183