| Theme | Diagnosis and Treatment of Non-ampullary Duodenal Epithelial Tumor -- Current Status and Issues | |
|---|---|---|
| Title | Endoscopic Diagnosis of Superficial Non-ampullary Duodenal Epithelial Tumors | |
| Publish Date | 2018/09 | |
| Author | Yosuke Tsuji | Department of Gastroenterology, The University of Tokyo Hospital |
| Author | Mitsuhiro Fujishiro | Department of Gastroenterology, The University of Tokyo Hospital / Department of Endoscopy and Endoscopic Surgery, The University of Tokyo Hospital |
| Author | Kazuhiko Koike | Department of Gastroenterology, The University of Tokyo Hospital |
| [ Summary ] | The incidence of superficial non-ampullary duodenal epithelial tumors (SNADET) has been increasing, although overall it remains fairly low. Endoscopists must carefully examine the descending duodenal segment to identify any protruded or depressed lesions, or whitish discoloration. A high-grade adenoma or adenocarcinoma could be diagnosed based on coloration, tumor diameter, or the distribution pattern of whitish discoloration, although there are exceptions. A targeted biopsy is not a highly accurate examination and is not superior to endoscopic diagnosis. A few reports describe submucosal fibrosis following a duodenal biopsy, which makes endoscopic resection a more difficult procedure. Presently, making endoscopic diagnosis as accurate as possible and performing a biopsy at a minimum are advisable for diagnosing SNADET. | |