Clinical Gastroenterology Vol.25 No.6(4)

Theme GIST : Current Progress on Diagnosis and Treatment
Title Diagnosis of Gastrointestinal Stromal Tumors (GISTs) with Conventional Endoscopy and Endoscopic Ultrasonography (EUS)
Publish Date 2010/06
Author Keiichi Sakamaki Department of Gastroenterology, Nagoya University Graduate School of Medicine
Author Ryoji Miyahara Department of Endoscopy, Nagoya University Hospital
Author Hidemi Goto Department of Gastroenterology, Nagoya University Graduate School of Medicine / Department of Endoscopy, Nagoya University Hospital
[ Summary ] Gastrointestinal stromal tumors (GISTs) are one type of submucosal tumor which exhibits particular endoscopic findings. These tumors generally present a smooth hemispherical appearance. When GISTs become enlarged and have ulcerations or multiple nodules, they are suspected to be malignant. EUS is important for differential diagnosis. GISTs generally originate from the muscle layer, and they are recognized as low echoic tumors. Their borders are often relatively clear and internal echoes show various image patterns, from homogeneous to heterogeneous. Sometimes, they exhibit high local spot echos or anechoic lesions within the tumor, indicating bleeding or necrosis. EUS-FNA is a safe and useful method for differential diagnosis of submucosal tumors by making it possible to produce estimates related to immunohistopathological findings. In this paper, we explain the characteristic findings of GISTs observed with conventional endoscopes as well as EUS.
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