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. 2021 Nov 20;11(11):2152.
doi: 10.3390/diagnostics11112152.

A Rare Case of Duodenal Pseudomelanosis

Marianna D'Ercole  1   2 , Gianluca Lopez  1   2 , Luca Elli  3 , Stefano Ferrero  1   4 , Giorgio Alberto Croci  1   5
Affiliations

A Rare Case of Duodenal Pseudomelanosis

Marianna D'Ercole et al. Diagnostics (Basel). .

Abstract

A black-spotted duodenal mucosa was observed during endoscopy of a man with several comorbidities including hypertension and end-stage kidney disease. Histopathological examination revealed pigment-laden macrophages in the lamina propria of the duodenal villi, which was consistent with duodenal pseudomelanosis.

Keywords: duodenal; duodeni; endoscopy; iron; pigmentation; pseudomelanosis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
A 75-year-old man underwent endoscopy for obstructive lithiasic cholangitis. His medical history included gastric resection for non-Hodgkin lymphoma, monoclonal gammopathy of undetermined significance (MGUS), HCV infection, hypertension, and stage 4 chronic kidney disease. His medications included furosemide, metoprolol, and amlodipine. During the endoscopy, the duodenal mucosa presented spotted black pigmentation at the tip of the villi (A). Duodenal biopsy samples stained with routine hematoxylin and eosin (B) showed aggregates of pigment-laden macrophages in the lamina propria of the apical portion of the villi, which tested intensely positive with Perl’s stain for iron; enterocytes demonstrated a faint positivity for Perl’s Prussian blue underneath the microvilli (B, inset). These findings were consistent for duodenal pseudomelanosis, a benign condition which harbors no known clinical sequelae [1,2,3,4,5,6,7,8,9,10,11,12,13].
See this image and copyright information in PMC

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