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

J. H. Kim, Young-Tae Bak, J. S. Kim, S. Y. Seol, Bong Kyung Shin, Han Kyeom Kim

Research output: Contribution to journalReview article

17 Citations (Scopus)

Abstract

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 whitishdiscolored 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 lymphangiectasiawere 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 lymphangiectasiawas 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 lymphangiectasiawithout clinical evidence of malabsorption is not extremely rare among cases undergoing routine upper gastrointestinal endoscopy.

Original languageEnglish
Pages (from-to)510-515
Number of pages6
JournalEndoscopy
Volume41
Issue number6
DOIs
Publication statusPublished - 2009 Dec 1

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Lymphangiectasis
Gastrointestinal Endoscopy
Endoscopy
Dental Caries
Dilatation
Prospective Studies
Medical Records
Retrospective Studies

ASJC Scopus subject areas

  • Gastroenterology

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Clinical significance of duodenal lymphangiectasia incidentally found during routine upper gastrointestinal endoscopy. / Kim, J. H.; Bak, Young-Tae; Kim, J. S.; Seol, S. Y.; Shin, Bong Kyung; Kim, Han Kyeom.

In: Endoscopy, Vol. 41, No. 6, 01.12.2009, p. 510-515.

Research output: Contribution to journalReview article

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abstract = "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 whitishdiscolored 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 lymphangiectasiawere 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 lymphangiectasiawas 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 lymphangiectasiawithout clinical evidence of malabsorption is not extremely rare among cases undergoing routine upper gastrointestinal endoscopy.",
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