Role of endoscopic miniprobe ultrasonography in diagnosis of submucosal tumor of large intestine

Abstract

AIM:To evaluate the role of miniprobe ultrasonography under colonoscope in the diagnosis of submucosal tumor of the large intestine, and to determine its imaging characteristics. METHODS:Thirty-five patients with submucosal tumors of the large intestine underwent miniprobe ultrasonography under colonoscope. The diagnostic results of miniprobe ultrasonography were compared with pathological findings of specimens by biopsy and surgical resection. RESULTS:Lipomas were visualized as hyperechoic homogeneous masses located in the submucosa with a distinct border. Leiomyomas were visualized as hypoechoic homogeneous mass originated from the muscularis propria. Leiomyosarcomas were shown with inhomogeneous echo and irregular border. Carcinoids were presented as submucosal hypoechoic masses with homogenous echo and distinct border. Lymphangiomas were shown as submocosal hypoechoic masses with cystic septal structures. Malignant lymphomas displayed as hypoechoic masses from mucosa to muscularis propria, while pneumatosis cystoids intestinalis originated from submucosa with a special sonic shadow. One large leiomyoma was misdiagnosed as leiomyosarcoma. CONCLUSION:Endoscopic miniprobe ultrasonography can provide precise information about the size, layer of origin, border of submucosal tumor of the large intestine and has a high accuracy in the diagnosis of submucosal tumor of the large intestine. Pre-operative miniprobe ultrasonography under colonoscope may play an important role in the choice of therapy for submucosal tumor of the large intestine.Zhou PH, Yao LQ, Zhong YS, He GJ, Xu MD, Qin XY. Role of endoscopic miniprobe ultrasonography in diagnosis of submucosal tumor of large intestine.

Risk factors for recurrence after transanal endoscopic microsurgery for rectal malignant neoplasm

“…At present, unfortunately, we are not able to correctly identify this group of patients. Nevertheless, the recent introduction of high-definition 20-MHz through-the-channel miniprobes seems to be a step toward the possibility of preoperatively identifying not only the T stage but also the depth of submucosal invasion [33]. The present series shows a significant difference in recurrence rate between pT1 sm1 (0%) and sm2-3 (22.7%).…”

“…It is difficult to objectively define preoperatively which lesion would better be removed by TEM instead of transabdominal surgery, or even if it would benefit from neoadjuvant therapy, which, associated with TEM, in uT2 lesions was reported to be as effective as abdominal radical surgery [15][16][17][18]. Nevertheless, it must be remembered that our series extended over 15 years and was affected by a great evolution in technology, such as the introduction of EUS 360° probes, an improvement in image definition, and the introduction of high-definition EUS 20-MHz through-the-channel miniprobes [33]. These innovations came together with a growing experience in the EUS technique.…”

Intestinal Submucosal Lipomas

“…Endoscopic ultrasonography can help delineate the size, border and layer of origin of these colonic submucosal lesions and may improve diagnostic accuracy, but the endoscopic appearances may be changed in cases with ulceration and the diagnose may be compromised [3,6,17,18]. Endoscopy was quite useful in our series.…”

Endosonogragphic features of lesions suggesting gastricectopic pancreas: experience of a single tertiary center

“…As long as the lesions keep on showing benign signs, histopathologic confirmation is not commonly yielded (11). EUS is a valuable procedure for diagnosis and for making decisions on resection for the subepithelial lesions of the upper GI tract (15)(16)(17)(18)(19). It is not possible to obtain deep tissue sampling with standard biopsy forceps, and surgical or endoscopic resection is not necessary for asymptomatic patients.…”