Abstract
A 79-year-old woman presented with refractory nausea, vomiting, and weight loss. EGD showed mucosal erythema and edema of the second part of the duodenum with lumen narrowing, leading to gastric outlet obstruction (GOO) (A). Endoscopic biopsy specimens showed mild focal nonspecific duodenitis. Subsequent EUS demonstrated a 23-mm (largest diameter) cystic structure in the duodenum arising from the muscularis propria (B). Specimens obtained by EUS-guided core needle biopsy showed atypical epithelium in the duodenal mucosa with acute inflammation and reactive changes.
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