Lopez Gianluca, D'Ercole Marianna, Ferrero Stefano, Croci Giorgio Alberto
Pathology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy.
School of Pathology, University of Milan, 20122 Milan, Italy.
Diagnostics (Basel). 2021 Oct 24;11(11):1974. doi: 10.3390/diagnostics11111974.
Duodenal pseudomelanosis (also known as pseudomelanosis duodeni) is a rare endoscopic incidental finding defined by a pigmentation limited to the apex of the intestinal villi, which requires histological confirmation. While its exact pathogenesis is still poorly understood, it appears free from clinical consequences. This condition is believed to be associated with oral iron intake, antihypertensive drugs containing a sulfur moiety (i.e., hydralazine, furosemide), and several chronic diseases (i.e., hypertension, end-stage renal disease, diabetes). However, the exact prevalence of these treatments and comorbidities among patients with duodenal pseudomelanosis is not clearly defined. Several case reports and case series about duodenal pseudomelanosis have been published in recent years. In this review, we aimed to clearly define its endoscopic and microscopic presentation; its epidemiology, associated comorbidities, and drugs; the most useful special histochemical techniques used to classify the nature of the pigmentation; and the most relevant differential diagnoses. In addition, by considering our findings, we also formulated a number of hypotheses about its pathogenesis.
十二指肠假黑色素沉着症（也称为十二指肠假黑色素沉着）是一种罕见的内镜偶然发现，其定义为仅限于肠绒毛顶端的色素沉着，这需要组织学证实。虽然其确切发病机制仍知之甚少，但似乎没有临床后果。这种情况被认为与口服铁剂、含硫部分的降压药（即肼屈嗪、呋塞米）以及几种慢性疾病（即高血压、终末期肾病、糖尿病）有关。然而，十二指肠假黑色素沉着症患者中这些治疗方法和合并症的确切患病率尚未明确界定。近年来已经发表了几篇关于十二指肠假黑色素沉着症的病例报告和病例系列。在本综述中，我们旨在明确界定其内镜和微观表现；其流行病学、相关合并症和药物；用于分类色素沉着性质的最有用的特殊组织化学技术；以及最相关的鉴别诊断。此外，通过考虑我们的发现，我们还对其发病机制提出了一些假设。
