case_images: PMC11032182_01
case_images: EGD findings. a Duodenal bulb. b 2nd portion of duodenum, area of stenosis seen distally. c 2nd portion of duodenum; ampulla is at the 9 o' clock position. d 3rd portion of duodenum (area of stenosis).
case_images: crg-2024-0018-0001-538489_F01.jpg
case_images: PMC11032182_01_crg-2024-0018-0001-538489_F01.jpg
case_images: F1
case_images: EGD revealed a severe duodenal stricture 4-5 cm distal to the ampulla (shown in Fig. 1), suspicious for extrinsic compression of the duodenum.
case_images: Contrast-enhanced CT of the abdomen and pelvis. a Coronal view of the abdomen: encircled (in yellow) is the mesenteric mass, encasing the distal portion of the duodenum, which also pulls down and tethers the duodenum. b Coronal view of the abdomen: yellow arrows point at the jejunum, exhibiting the mass which is inseparable from the jejunum, with likely jejunal collapse. c Axial view of the abdomen: encircled is the mesenteric mass at the axial cross section.
case_images: crg-2024-0018-0001-538489_F02.jpg
case_images: PMC11032182_01_crg-2024-0018-0001-538489_F02.jpg
case_images: F2
case_images: Abdominal and pelvic contrast-enhanced computed tomography (CT) scan revealed a 5.0 x 3.7 x 4.3-cm mass within the mesentery, encasing the distal portion of the duodenum (shown in Fig. 2), with no signs of obstruction, possibly representing a neoplasm of mesenteric or small bowel origin.
case_images: Histopathology. a Microscopic examination reveals spindled cells of uniform appearance and pale cytoplasm in a collagenous stroma with fascicles to herringbone pattern (x20). b Immunohistochemical stain reveals beta-catenin nuclear staining in fibroblasts (x20).
case_images: crg-2024-0018-0001-538489_F03.jpg
case_images: PMC11032182_01_crg-2024-0018-0001-538489_F03.jpg
case_images: F3
case_images: Microscopic examination revealed the jejunal mesenteric mass to be fibroblastic/myofibroblastic, with uniform spindle cells arranged in sweeping fascicles (shown in Fig. 3).