2018
DOI: 10.1002/dc.24040
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Endoscopic ultrasound FNA: An illustrated review of spindle cell neoplasms of the upper gastrointestinal tract including a novel case of gastric plexiform fibromyxoma

Abstract: Plexiform fibromyxoma (PF) is a recently-described and rare mesenchymal neoplasm of the gastric wall. A few small case series reports of this spindle cell entity exist in the surgical pathology literature, but to our knowledge no prior endoscopic ultrasound guided fine needle aspiration cytology examples have been reported. In clinical practice, mural gastrointestinal (GI) lesions are often initially evaluated by endoscopic ultrasound guided (EUS) fine needle aspiration (FNA). In addition, newer EUS fine needl… Show more

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Cited by 15 publications
(18 citation statements)
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“…Conservative management included endoscopic resection and nonsurgical intervention. Since PF is currently considered a benign disease (though not yet verified by convincing evidence), conservative management may be suitable for PF patients, and particularly for the elderly or selected patients with surgically contraindicated comorbidities [72]; at least, more conservative surgical management than partial gastrectomy could be feasible [23]. However, vascular and lymphatic invasion were reported by Miettinen et al and Kawara et al [11, 60], and PF usually develops in a nodular and plexiform pattern with unclear tumor margins [1, 30, 64], suggesting that the possibility of malignancy or local recurrence cannot be fully excluded [9, 73].…”
Section: Treatmentmentioning
confidence: 99%
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“…Conservative management included endoscopic resection and nonsurgical intervention. Since PF is currently considered a benign disease (though not yet verified by convincing evidence), conservative management may be suitable for PF patients, and particularly for the elderly or selected patients with surgically contraindicated comorbidities [72]; at least, more conservative surgical management than partial gastrectomy could be feasible [23]. However, vascular and lymphatic invasion were reported by Miettinen et al and Kawara et al [11, 60], and PF usually develops in a nodular and plexiform pattern with unclear tumor margins [1, 30, 64], suggesting that the possibility of malignancy or local recurrence cannot be fully excluded [9, 73].…”
Section: Treatmentmentioning
confidence: 99%
“…Therefore, regardless of the operative technique, we suggest that complete resection still be the first consideration when treating PF rather than consideration of the conservativeness of the operative technique [30, 64, 71]. PF cases with severe clinical presentations, such as perforation [1, 21], infection [36], or considerable hemorrhage [53, 58, 63, 74], and with malignant suspicion, such as significant body weight loss [11, 72] or rapid tumor growth [16], should be addressed with aggressive radical surgical treatment rather than conservative management, despite the benign pathological results.…”
Section: Treatmentmentioning
confidence: 99%
“…16 Accurate preoperative diagnosis of schwannoma may be important since the submucosal tumors of gastrointestinal tract have been increasingly resected via an endoscopic approach, 17-21 EUS-FNA is the most effective method to diagnose gastric submucosal masses. [5][6][7][8][9] However, a nondiagnostic or indeterminate diagnosis may be seen in a small subset of cases due to insufficient cellularity and lack of cell block material for ancillary studies. For the cases with inadequate FNA sampling, additional trucut or mucosal cutting biopsy may be beneficial for improvement of diagnostic yield and proper clinical management.…”
Section: Case Reportmentioning
confidence: 99%
“…[5][6][7][8][9] Although the cytomorphologic features of schwannoma are well described, [10][11][12][13] there are only a few case reports of gastric schwannoma in the literature. [5][6][7][8][9] Although the cytomorphologic features of schwannoma are well described, [10][11][12][13] there are only a few case reports of gastric schwannoma in the literature.…”
Section: Introductionmentioning
confidence: 99%
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