Diagnostic utility of EUS-guided FNA in patients with gastric submucosal tumors

Mekky, Mohamed A.; Yamao, Kenji; Sawaki, Akira; Mizuno, Nobumasa; Hara, Kazuo; Nafeh, Mohamed; Osman, Ashraf; Koshikawa, Takashi; Yatabe, Yasushi; Bhatia, Vikram

doi:10.1016/j.gie.2009.11.044

Cited by 208 publications

(243 citation statements)

References 23 publications

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“…Interestingly, there was no significant difference in diagnostic yield for the different needle sizes or the number of passes. There have been similar findings in other studies [14,16].…”

supporting

confidence: 91%

“…These findings make sense conceptually, but they have not been replicated consistently in other studies. For instance, the anatomic location of GISTs has not been demonstrated to improve diagnostic yield [14,16], whereas improved yield with increasing size of the lesion has been suggested [15,16]. However, it has also been reported that the yield may actually decrease, presumably because of necrosis, if the lesion size is [10 cm [15].…”

mentioning

confidence: 99%

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EUS-Guided Fine Needle Aspiration of Gastrointestinal Stromal Tumors: The GIST of the Matter

Chandrasekhara

Ahmad

2011

Dig Dis Sci

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“…Interestingly, there was no significant difference in diagnostic yield for the different needle sizes or the number of passes. There have been similar findings in other studies [14,16].…”

supporting

confidence: 91%

mentioning

confidence: 99%

EUS-Guided Fine Needle Aspiration of Gastrointestinal Stromal Tumors: The GIST of the Matter

Chandrasekhara

Ahmad

2011

Dig Dis Sci

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“…EUS-FNA biopsy is currently considered the standard method for samples of submucosal tumors (SMTs). Mekky et al [8] reported that EUS-guided FNA was an accurate method for the diagnosis of gastric SMTs, and the diagnostic yield was 43.3 %. Recently, de la Serna-Higuera et al [9] reported that EUS-guided needle-knife incision and forceps biopsy (SINK biopsy) could be a reliable alternative to conventional FNA, providing larger samples that improve the histologic yield for upper gastrointestinal (GI) subepithelial tumors (SETs), but there are few reports about SINK biopsy and it is not yet an established technique.…”

Section: Discussionmentioning

confidence: 99%

Gastric schwannomas revisited: has precise preoperative diagnosis become feasible?

et al. 2012

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Background Gastric schwannomas are not common but are clinically important in terms of differential diagnosis from other submucosal lesions. The precise preoperative diagnosis, however, has been challenging mainly owing to the lack of specific findings in conventional imaging studies. The aim of this study was to revisit the possibilities and limitations of modern preoperative diagnostic modalities for gastric schwannomas. Methods Fourteen consecutive patients with a final pathological diagnosis of gastric schwannoma were retrospectively analyzed. Data included demographics, preoperative imaging studies/diagnosis, surgery, histopathology, and follow-up results.Results The series included 6 males and 8 females, with a median age of 49 years (range 26-68 years). No symptoms were presented, except for 1 patient with epigastric pain. The tumors were located in the upper (n = 5), middle (3), and lower stomach (6), with a median size of 41 mm (range 20-75 mm). Twelve schwannomas (86 %) showed homogeneous enhancement on computed tomography. Ulceration was seen on endoscopy in 4 of 12 available cases (33 %). Positron emission tomography was performed in the last 4 patients, showing fluorodeoxy-glucose uptake in all cases (100 %). A preoperative diagnosis of schwannoma was not obtained in the majority of cases (13/14, 93 %); only 1 case was correctly diagnosed, by endoscopic aspiration cytology. Laparoscopic partial gastrectomy was attempted and completed in 13 cases. The patients have been followed up for 4.7 years (range 2.1-20.3 years), with no recurrencesor metastases and acceptable gastrointestinal function. Conclusions The precise preoperative diagnosis of gastric schwannomas remains difficult even with modern imaging studies. Surgery, therefore, should be positively considered for patients without a conclusive preoperative diagnosis.

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“…The definitive cytological and/or histological verification of larger gastric GIST is currently achieved in 50%-70% of EUS-guided fineneedle aspiration (FNA) or EUS-guided Trucut punch biopsies [10][11][12][13][14][15] . The histological diagnosis of GIST requires immunohistochemical detection of CD117 and particularly in CD117-negative tumors of DOG1 with the corresponding histomorphological findings.…”

Section: Eus and Eus-fnamentioning

confidence: 99%

Management of early asymptomatic gastrointestinal stromal tumors of the stomach

Scherübl

Faiss

Knoefel

et al. 2014

WJGE

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Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract. Approximately two thirds of clinically manifest tumors occur in the stomach, nearly one third in the small bowel, and the rest in the colorectal region with a few cases in the esophagus. GIST originate within the smooth muscle layer in the wall of the tubular gastrointestinal tract and grow mostly toward the serosa, far less often toward the mucosa. In the latter case, ulceration may develop and can cause gastrointestinal bleeding as the cardinal symptom. However, most GIST of the stomach are asymptomatic. They are increasingly detected incidentally as small intramural or submucosal tumors during endoscopy and particularly during endoscopic ultrasound. Epidemiological and molecular genetic findings suggest that early asymptomatic GIST of the stomach (< 1 cm) show self-limiting tumorigenesis. Thus, early (< 1 cm) asymptomatic gastric GIST (synonym: micro-GIST) are found in 20%-30% of the elderly. The mostly elderly people with early gastric GIST have an excellent GIST-specific prognosis. Patients with early GIST of the stomach can therefore be managed by endoscopic surveillance.

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Diagnostic utility of EUS-guided FNA in patients with gastric submucosal tumors

Cited by 208 publications

References 23 publications

EUS-Guided Fine Needle Aspiration of Gastrointestinal Stromal Tumors: The GIST of the Matter

EUS-Guided Fine Needle Aspiration of Gastrointestinal Stromal Tumors: The GIST of the Matter

Gastric schwannomas revisited: has precise preoperative diagnosis become feasible?

Management of early asymptomatic gastrointestinal stromal tumors of the stomach

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