Clinical Gastroenterology Vol.20 No.11(6)

Theme Present Status and Future Aspects of EUS
Title Differential Diagnosis of Gastrointestinal Submucosal Tumors with Endoscopic Ultrasonography
Publish Date 2005/10
Author Yasumasa Niwa Department of Gastroenterology, Nagoya University Hospital
Author Akira Ohashi Department of Gastroenterology, Nagoya University Hospital
Author Ryouji Miyahara Department of Gastroenterology, Nagoya University Hospital
Author Yoshiki Hirooka Department of Endoscopy, Nagoya University Hospital
Author Hidemi Goto Department of Gastroenterology, Nagoya University Hospital
[ Summary ] For differential diagnosis of gastrointestional sub-mucosal tumors, it is extremely important to evaluate internal tumor structures and relation to the alimentary wall with endoscopic ultrasonography (EUS). We can make a diagnosis of malignancy in gastrointestional stromal tumors (GIST) by evaluating (1) tumor diameter, (2) presence inside the echo-free space, (3) the irregular border of tumors. The evaluation of GIST with EUS has a great impact on determination of treatment plans. EUS-guided fine needle aspiration biopsy (EUS-FNAB) should be applied for cases where it is difficult to determine of treatment plans even with EUS and other examination methods. Immunohistological investigation with EUS-FNAB for diagnosis of GIST is useful when it is difficult to evaluate malignancy with conventional EUS. However, a gold standard to evaluate malignancy with GIST has not been established, so we must make diagnoses with EUS images and immunohistological features in comprehensive ways.
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