Is it possible to differentiate gastric GISTs from gastric leiomyomas by EUS?

Kim, Gwang Ha; Park, Do Youn; Kim, Suk; Kim, Dae Hwan; Kim, Dong Heon; Choi, Cheol Woong; Heo, Jeong; Song, Geun Am

doi:10.3748/wjg.15.3376

Cited by 76 publications

(99 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Echogenicity is usually associated with a histology of cellularity and homogeneity of the lesion in other solid organs [21][22][23]. Although correlation studies of US and histopathology in thyroid nodules are rare, it was thought that hypoechogenicity was due to compaction, fibrosis, and high cellularity [24,25].…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-Based Risk Stratification for Malignancy in Thyroid Nodules: A Four-Tier Categorization System

Seo

Na²,

Kim

et al. 2015

Eur Radiol

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Ultrasound-Based Risk Stratification for Malignancy in Thyroid Nodules: A Four-Tier Categorization System

Seo

Na²,

Kim

et al. 2015

Eur Radiol

View full text Add to dashboard Cite

show abstract

“…On EUS ( Figure 1C, D), a GIST is typically a well-circumscribed, hypoechoic, relatively homogeneous mass that can arise from either the second hypoechoic layer (muscularis mucosa) or more frequently the fourth hypoechoic layer (muscularis propria). In addition to size and mucosal ulcer, other EUS characteristics have been considered as possible predictive factors, but size is the only consistently definitive predictive factor [45][46][47][48]. One study suggested that GISTs have a marginal hypoechoic halo and relatively higher echogenicity compared with the adjacent muscular layer [49].…”

Section: Gastrointestinal Stromal Tumors (Gist)mentioning

confidence: 99%

Role of Endoscopic Ultrasound in Subepithelial Lesions (SELs)

Al-Lehibi¹,

Bamakhrama²

2017

Endoscopic Ultrasound - From Usual to Special

View full text Add to dashboard Cite

A subepithelial lesion (SET) is defined as a lesion, bulge or impression visible within the lumen of the gastrointestinal tract that is covered by normally appearing mucosa and usually found incidentally during routine endoscopy. Such a lesion could be either an intramural mass or an impression caused by extramural structures. The old terminology has recently been replaced by the term "subepithelial lesion" because intramural lesions may arise and can be located in any layer of the GI wall underneath the epithelium. The most common SELs are gastrointestinal stromal tumors (GISTs), leiomyomas, lipomas, granular cell tumors (GCTs), pancreatic rests and carcinoid tumors. The prognosis varies from benign to potentially malignant. While the majority of the lesions are considered benign, some tumors such as GISTs and carcinoids have a strong propensity for malignant transformation. Endoscopic ultrasonography (EUS) is the most accurate diagnostic method for distinguishing between extraluminal compressions and intramural lesions and plays a critical role in the detection and management of SELs. This is because EUS can reveal the precise sonographic nature of the lesion even though sometimes there are complex cases, which are difficult to diagnose by EUS alone. Performing routine biopsies and obtaining tissue samples for diagnosis can be difficult because SELs are located beneath the normal epithelial layer. Mostly, EUS allows the practitioner to extract an optimal tissue sample since it allows fine-needle aspiration (FNA) and fine-needle biopsy (FNB) both of which provide good results. With immunocytochemical staining, all these techniques increase the accuracy of the diagnosis. Evaluation of subepithelial lesions by means of EUS imaging will provide further characterization of the lesion to help guide us in appropriate differential diagnosis and further management. In this chapter, we provide a systematic EUS-guided approach to the diagnosis, management and later surveillance for SELs, as well as presenting updated diagnostic techniques that may help physicians to appropriately manage these subepithelial lesions.

show abstract

“…Leiomyomas appear endosonographically as small (< 5 cm) homogenous, hypoechoic SMTs, with smooth/distinct borders, originating from the forth or second wall layer [8] . Signs like inhomogenicity, hyperechogenic spots, a marginal halo and higher echogenicity compared to the surrounding muscle layer might appear more frequently in GISTs than in leiomyomas [35] , but differentiation based merely on imaging is risky and therefore should be done only in specific conditions and with the informed of the patient. For larger lesions, surgical resection seems to be the best alternative; (2) Extrinsic compressions: Compressions on the gastric wall from organs neighboring the stomach may occasionally present as SMLs and sometimes can cause diagnostic problems.…”

Section: Miscellaneous Smls In Eusmentioning

confidence: 99%

Endoscopic ultrasonography for gastric submucosal lesions

Papanikolaou

Triantafyllou²,

Κourikou³

et al. 2011

WJG

View full text Add to dashboard Cite

Gastric submucosal tumors (SMTs) are a rather frequent finding, occurring in about 0.36% of routine upper GIendoscopies. Endoscopic ultrasonography (EUS) has emerged as a reliable investigative procedure for evaluation of these lesions. Diagnostic EUS has the ability to differentiate intramural tumors from extraluminal compressions and can also show the layer of origin of gastric SMTs. Tumors can be further characterized by their layer of origin, echo pattern and margin. EUS-risk criteria of their malignant potential are presented, although the emergence of EUS-FNA has opened new indications for transmural tissue diagnosis and expanded the possibilities of EUS in SMTs of the stomach. Tissue diagnosis should address whether the SMT is a Gastrointestinal stromal tumour (GIST) or another tumor type and evaluate the malignant potential of a given GIST. However, there seems to be a lack of data on the optimal strategy in SMTs suspected to be GISTs with a negative EUS-FNA tissue diagnosis. The current management strategies, as well as open questions regarding their treatment are also presented.

show abstract

Is it possible to differentiate gastric GISTs from gastric leiomyomas by EUS?

Abstract: EUS may help to differentiate gastric GISTs from gastric leiomyomas. Once GISTs are suspected, surgery should be considered if the size is greater than 3.5 cm.

Cited by 76 publications

References 17 publications

Ultrasound-Based Risk Stratification for Malignancy in Thyroid Nodules: A Four-Tier Categorization System

Ultrasound-Based Risk Stratification for Malignancy in Thyroid Nodules: A Four-Tier Categorization System

Role of Endoscopic Ultrasound in Subepithelial Lesions (SELs)

Endoscopic ultrasonography for gastric submucosal lesions

Contact Info

Product

Resources

About