| Theme |
Present Status and Future Aspects of EUS |
| Title |
Differential Diagnosis of Gastrointestinal Submucosal Tumors with Endoscopic Ultrasonography |
| 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. |