Case report: hypoechoic submucosal nodules: a sign of Epstein-Barr virus-associated early gastric cancer.
The Epstein-Barr virus (EBV) has been reported to be detectable in about 10% of gastric carcinomas. We performed a comparative study of endosonographic findings of EBV-positive and -negative early gastric carcinomas. Epstein-Barr virus was detected in 11.8% (four of 34) of endosonographically observed early gastric carcinoma lesions. Endoscopic ultrasonography (EUS) revealed a hypoechoic mass in the third layer, which reflected submucosal nodules, in 75% (three of four) of EBV-associated lesions. Endoscopically, in 66.7% (two of three) of EBV-associated carcinomas, the depressed lesion was surrounded by a raised margin covered with normal mucosa and was similar to a submucosal tumour (P < 0.05). Histologically, all three cases of EBV-associated lesions with submucosal tumour invasion had submucosal nodules of carcinoma with lymphoid stroma and 75% (three of four) were located in the gastric body. The ratio of maximal thickness to width of EBV-associated lesions was significantly larger than that of EBV-negative lesions, and this tendency was marked in lesions with submucosal tumour invasion (P < 0.05). This study indicated that EUS and endoscopy are of great use for the determination of EBV association with early gastric carcinoma.
First Department of Internal Medicine, Yamaguchi University School of Medicine, Japan.
J
J
Nishikawa
H
H
Yanai
Y
Y
Mizugaki
K
K
Takada
M
M
Tada
K
K
Okita
D000328:Adult; D000368:Aged; D019160:Endosonography; D005260:Female; D005753:Gastric Mucosa; D006566:Herpesviridae Infections / Q000000981:diagnostic imaging* / Q000473:pathology; D004854:Herpesvirus 4, Human / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000821:virology*; D014412:Tumor Virus Infections / Q000000981:diagnostic imaging* / Q000473:pathology