A Rare Case of Duodenal Adenocarcinoma Presenting as a Subepithelial Lesion in a Patient Undergoing Investigation for Iron Deficiency Anaemia

Figure 1

Macroscopic and microscopic views of the duodenal adenocarcinoma. (a) Appearance of the lesion on endoscopy showing central depression but otherwise unremarkable overlying mucosa. (b) Low power. Microphotography of the duodenal lesion with an inverted pattern of growth and normal appearing overlying mucosa. (c) Medium power. Microphotography of the duodenal lesion shows tightly packed tubules consistent with pyloric gland origin. (d) Medium power. Focus of the invasive duodenal adenocarcinoma with cytological atypia, nuclear pleomorphism, and increased nuclear to cytoplasmic ratio consistent with malignancy. (e) Medium power. Immunohistochemistry of the duodenal lesion shows extensive positive staining for gastric-type mucin MUC6, a marker consistent with pyloric gland origin.

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