Prospective comparison of endoscopic ultrasound-guided fine-needle aspiration and surgical histology in upper gastrointestinal submucosal tumors

Philipper, Michael; Hollerbach, Stephan; He, Guimei; Heikaus, Sebastian; Böcking, Alfred; Pomjanski, Natalia; Neuhaus, H.; Frieling, T; Schumacher, Brigitte

doi:10.1055/s-0029-1244006

Cited by 124 publications

(137 citation statements)

References 21 publications

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“…Meanwhile, surgical excision is generally recommended for SETs that are [5 cm, and histologic assessment is necessary for SETs between 2 and 5 cm [13]. EUS-FNA has been recommended for histologic assessment; however, the diagnostic efficacy of this technique appears to be limited [14]. Recently, EUS-guided SINK biopsy has been reported to be an easy, safe, and effective technique for the diagnosis of SETs [11].…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic yield of endoscopic ultrasonography-guided single-incision needle knife biopsy for gastric subepithelial tumors: comparison with resected specimens

Kim

et al. 2016

Surg Endosc

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Section: Discussionmentioning

confidence: 99%

“…However, both FNA and TCB have low diagnostic yields of 34-63 % [14,[17][18][19]. Also, technical failure was observed in 18 % of FNA cases and 14 % of TCB cases [20,21].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic yield of endoscopic ultrasonography-guided single-incision needle knife biopsy for gastric subepithelial tumors: comparison with resected specimens

Kim

et al. 2016

Surg Endosc

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“…Numerous prospective trials attempted to identify EUS signs of malignancy [47,48] and recorded the accuracy of EUS-FNA and EUS trucut biopsy in sampling gastrointestinal stromal and other submucosal tumors (IIb) [49,50], yet conclusions are discordant and data from controlled or randomized studies are warranted. A continuous effort to expand EUS applications is reflected on the considerable number of studies regarding emerging and other indications.…”

Section: Resultsmentioning

confidence: 99%

Levels of Evidence in Endoscopic Ultrasonography: A Systematic Review

et al. 2011

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“…However, endoscopic biopsy performed using standard biopsy forceps most often leads to unremarkable results. Recently, the use of EUS-FNA has emerged as an important diagnostic technique for SMT (23). However, as this method exhibits limited diagnostic accuracy due to the small amount of tissue that can be collected, an improved method, such as ESD-based intervention or surgery, is required for tissue sampling (24).…”

Section: Discussionmentioning

confidence: 99%

Gastric heterotopic pancreas masquerading as a stromal tumor: A case report

Lin

et al. 2015

Oncology Letters

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Abstract. Heterotopic pancreas (HP), a rare condition that is generally asymptomatic, is an aberration in the developmental profile of the pancreas. While it can occur in any location in the gastrointestinal tract, it is most typically found in the antrum of the stomach and is usually wrongly considered to be a submucosal tumor (SMT). Despite advances in diagnostic modalities, a HP still poses a diagnostic dilemma to clinicians. Invasive surgery or endoscopic resection have often been inappropriately applied in cases of an ectopic pancreas due to the difficulty in distinguishing it from neoplastic SMTs, such as gastrointestinal stromal tumors (GISTs). The present study reports the unusual case of a middle-aged female with an SMT at the lesser curve of the mid-body of the stomach, which was initially diagnosed as a GIST through endoscopic ultrasonography and computed tomography. However, following removal by endoscopic submucosal dissection, this lesion was finally histopathologically confirmed as an HP. Therefore, although it is rare, the possibility of an HP should always be considered when diagnosing an extramucosal gastric mass. The precise pre-operative diagnosis of this entity may avoid unnecessary extensive treatment intervention. IntroductionHeterotopic pancreas (HP), also known as ectopic or aberrant pancreas, is a congenital disorder with an occurrence rate of 0.5-13% in the general population (1). HP has no any vascular or anatomical communication with the normal pancreas, yet exhibiting the histological features of pancreatic acinar formation, the development of ducts and the presence of islets of Langerhans, with an independent blood supply (2-4). The heterotopic organ often remains silent, but may occasionally be symptomatic, including gastrointestinal bleeding, gastric outlet obstruction, gastric ulceration, pancreatitis and even malignant degeneration (5-7).Appearing as intraluminal protrusions with normal overlying mucosa, HPs are usually diagnosed as submucosal tumors (SMTs) at first during routine endoscopy. Despite the advent of novel diagnostic modalities, including endoscopic ultrasonography (EUS), computer tomography (CT) and even EUS-guided fine-needle aspiration (EUS-FNA), the differentiation from a neoplasm remains a clinical challenge (8-10). Invasive surgery or endoscopic resection are often inappropriately performed in HP cases due to tissue sampling errors and the difficulty in forming a pre-operative diagnosis on imaging (11,12). However, asymptomatic HP is benign and can be monitored long-term without further intervention. Therefore, the ability to pre-operatively distinguish HPs from neoplastic SMTs, such as gastrointestinal stromal tumors (GISTs), is extremely important.The present study describes a case with a lesion located on the lesser curvature of the gastric body, which was initially diagnosed as GIST through EUS and CT, until finally being confirmed as an HP. The study also presents a brief literature review concerning this relatively rare disorder. Written informed consen...

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Prospective comparison of endoscopic ultrasound-guided fine-needle aspiration and surgical histology in upper gastrointestinal submucosal tumors

Abstract: EUS-FNA-based cytology is safe and has only limited value for the differential diagnosis of submucosal tumors, mainly because insufficient material is harvested. Better tissue acquisition techniques are necessary for better differential diagnosis.

Cited by 124 publications

References 21 publications

Diagnostic yield of endoscopic ultrasonography-guided single-incision needle knife biopsy for gastric subepithelial tumors: comparison with resected specimens

Diagnostic yield of endoscopic ultrasonography-guided single-incision needle knife biopsy for gastric subepithelial tumors: comparison with resected specimens

Levels of Evidence in Endoscopic Ultrasonography: A Systematic Review

Gastric heterotopic pancreas masquerading as a stromal tumor: A case report

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