Endoscopic Ultrasonography in the Diagnosis of Gastric Submucosal Tumor

Abstract

Endoscopic ultrasonography (EUS) can display the gastric wall as a 5-layered structure corresponding to its histological layers. It can be used not only in differentiating gastric mural lesions from extragastric compression, also it can be used to delineate the size, location and extent of invasion of the submucosal tumors. From Oct. 1986 through July 1991, there were 31 cases which received EUS examination because of suspected gastric submucosal tumors. Histological diagnoses or documented extrinsic compression could be obtained in 23 cases. Of these, 20 cases (86.9%) were correctly diagnosed as to the origine of lesions but in only 15 cases (65.2%) were the ocrrect histological diagnoses made with EUS. Myogenic tumor is the most common gastric submucosal tumor; also, it is the tumor most frequently associated with reliable ultrasonic signs for histological diagnosis. Lymphoma & scirrhous carcinoma are other tumors in which EUS may make correct histological diagnosis but EUS tends to miss the subtle change of mucosa and thus may underestimate the extent of invasion. Although EUS is limited by lacking of specificity in differentiating between benign and malignant lesions and in making histological diagnoses of several kinds of submucosal tumors, it is still a useful tool when a suspected gastric submucosal tumor or a suspected extragastric compression is encountered.