Home   Case of Week Home   Jobs  Conferences   Fellowships   Books

Case of the Week #231

2 February 2012 - Case of the Week #231

All cases are archived on our website. To view them sorted by number, diagnosis or category, visit our Home Page and click on the Case of the Week button on the left hand side. To subscribe or unsubscribe to the Case of the Week or our other email lists, click here.

Thanks to Dr. Jamie Shutter, East Carolina University Brody School of Medicine, for contributing this case. To contribute a Case of the Week, follow the guidelines on our Case of the Week page.

Rabbit Monoclonal Antibodies for Anatomic Pathology

Rabbit Monoclonal Antibodies (RabMAbs) provide the combined benefits of superior antigen recognition of the rabbit immune system, and the specificity and consistency of a monoclonal antibody (mAb), providing stronger staining than mouse mAbs with no loss in specificity (Am J Clin Pathol 2005;124:295, Pathol Res Pract 2008;204:655).

We conducted several comparison studies of our rabbit mAb EP Clones versus mouse mAbs for the same target on the same tissue sample. Visit www.epitomics.com/compare to see the results of these comparisons.

Our expanding product portfolio of EP Clones has over 100 rabbit monoclonal antibodies in 16 different panels including: c-Myc, Cyclin PMS2, MSH6, ERG, PSA and more. To see our full antibody listing, click here.


Website news:

(1) Check out our new CME page, which has a link on the left side of the Home page.

(2) We have increased our Case of the Week payment for contributors to $50. Just send us diagnostic images, the diagnosis and a brief clinical history. We will write up the discussion (unless you want to). Right now, our queue is relatively short, so cases submitted will be posted soon. Send your materials to NatPernick@hotmail.com

(3) We posted an article on our Management Page, Thoughts for the New Year (2012), by Mick Raich, Vachette Pathology, click here.

Case of the Week #231

Clinical History:

94 year old woman with GI bleed presents for upper and lower endoscopy. Endoscopist notes spotty hyperpigmentation throughout duodenum without other associated abnormalities."

Micro images:


What is your diagnosis?


Melanosis duodeni


Melanosis duodeni, also known as pseudomelanosis duodeni, is due to brown-black pigment in macrophages in the lamina propria of the proximal duodenum. It is often, but not always, identified at endoscopy. It is due to iron or sulfur (J Formos Med Assoc 1995;94:632), and may be associated with oral iron intake, hypertension, diabetes or end stage renal disease (Endoscopy 2008;40:165). It is not associated with laxative abuse (J Clin Gastroenterol 1988;10:127). It is also not associated with lipofuscin pigment, which is identified in melanosis coli.

Melanosis duodeni has no known clinical significance.

Nat Pernick, M.D., President
and Liz Parker, B.A., Associated Medical Editor
PathologyOutlines.com, Inc.
30100 Telegraph Road, Suite 408
Bingham Farms, Michigan (USA) 48025
Telephone: 248/646-0325
Email: NatPernick@Hotmail.com
Alternate email: NatPernick@gmail.com