Endoscopy 2009; 41(6): 510-515
DOI: 10.1055/s-0029-1214611
Original article

© Georg Thieme Verlag KG Stuttgart · New York

Clinical significance of duodenal lymphangiectasia incidentally found during routine upper gastrointestinal endoscopy

J.  H.  Kim1 , 2 , Y.  T.  Bak1 , J.  S.  Kim1 , S.  Y.  Seol2 , B.  K.  Shin3 , H.  K.  Kim3
  • 1Department of Gastroenterology, Korea University Guro Hospital, Seoul, Korea
  • 2Department of Gastroenterology, Inje University College of Medicine, Busan, Korea
  • 3Department of Pathology, Korea University Guro Hospital, Seoul, Korea
Weitere Informationen

Publikationsverlauf

submitted 8 July 2008

accepted after revision 3 March 2009

Publikationsdatum:
16. Juni 2009 (online)

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Background and study aim: Although duodenal lymphangiectasia in individuals without clinical evidence of malabsorption has been reported, the prevalence and clinical significance in this situation are not yet known. The aim of this study was to evaluate the prevalence and clinical significance of incidentally found duodenal lymphangiectasia.

Patients and methods: A retrospective review of medical records was undertaken for consecutive patients who had undergone diagnostic upper endoscopy between January 2005 and June 2006. A prospective study was then performed in consecutive individuals undergoing routine upper endoscopy for health examination between July 2006 to October 2006. Endoscopic features of duodenal lymphangiectasia were classified into three types: (1) multiple scattered pinpoint white spots; (2) diffuse prominent villi with whitish-discolored tips; and (3) focal small whitish macule or nodule. The histologic grade of duodenal lymphangiectasia was classified according to the depth and severity of lymphatic duct dilatations. Prevalence and clinical data of incidentally found duodenal lymphangiectasia were evaluated in the retrospective and prospective studies.

Results: Among 1866 retrospective cases, duodenal lymphangiectasia was endoscopically suspected in 59 cases (3.2 %), and histologically confirmed in 35 cases (1.9 %). No clinical evidence of malabsorption was noted in the duodenal lymphangiectasia cases. The ”scattered pinpoint white spots” type was the most frequently found endoscopic feature (40.0 %). Duodenal lymphangiectasia was persistent in seven of 10 individuals who underwent repeat endoscopy after a median of 12 months. Among 134 prospective cases, duodenal lymphangiectasia was histologically confirmed in 12 cases (8.9 %). There was no significant clinical difference between groups with and without duodenal lymphangiectasia. Lymphatic duct dilatation was histologically more severe in the ”focal small whitish macule or nodule” type than in the other types.

Conclusion: Duodenal lymphangiectasia without clinical evidence of malabsorption is not extremely rare among cases undergoing routine upper gastrointestinal endoscopy.

References

Y. T. Bak, MD

Department of Gastroenterology
Korea University Guro Hospital

97 Gurodong-gil
Guro-gu
Seoul 152-703
Korea

Fax: +82-505-1151778

eMail: drbakyt@korea.ac.kr