Figure 1

Diffuse Duodenal Nodular Lymphoid Hyperplasia. 35 year male presented with epigastric pain, vomiting and weight loss of 5 kg over the past 6 months. Duodenal composite images. Top left image: Duodenal bulb revealed smooth mucosa without any nodular lesion. Top right and 2 bottom images: post-bulbar region, second and third part of duodenum showed diffuse numerous mucosal nodules (>5 mm size each) scored as grade 4 disease. There was complete loss of Kerckring's folds. Duodenal biopsies revealed nodular lymphoid hyperplasia. Immunoglobulin revealed mild elevation of IgG level [IgG 2090 mg/dl (normal 700-1600 mg/dl); IgM. 120 mg/dl (normal = 40-230 mg/dl); IgA 145 mg/dl (normal = 70-400 mg/dl)].