[Accuracy of endoscopic ultrasonographic impression compared with pathologic diagnosis in gastrointestinal submucosal tumors].
OBJECTIVE
Endoscopic ultrasonography (EUS) is a valuable imaging modality for the evaluation of gastrointestinal submucosal tumor (SMT). EUS is helpful in assessing the layer of origin, tumor diameter, shape, border characteristics, and internal echo patterns of SMTs and thus makes it possible to predict histologic diagnosis with educated guess. However, some studies have found no significant differences in EUS features between benign and malignant mesenchymal tumors. By comparing EUS impressions with histologic diagnosis, we evaluated the accuracy of EUS in differential diagnosis of gastrointestinal SMTs.


METHODS
58 cases of gastrointestinal SMTs with both EUS findings and pathologic reports were compared retrospectively from August 2001 to September 2003.


RESULTS
34 patients had lesions in the stomach and 13, 8, 3 in the esophagus, duodenum, and colon respectively. Benign lesions were predominant (46 of 58). The EUS and pathologic diagnosis coincided in 46/58 (79.3%) of the cases. Use of EUS led to the correct diagnosis in 7/9 (77.8%) of malignant GISTs (gastrointestinal stromal tumor) and leiomyosarcomas. Two small malignant gastric GISTs were diagnosed as benign with EUS.


CONCLUSIONS
EUS is a useful tool in the differential diagnosis of gastrointestinal SMTs and predicting malignant lesions. However, some malignant GISTs were diagnosed as benign tumor with EUS examination.
Kwon
Joong Goo
JG
Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.
Kim
Eun Young
EY
Kim
Young Sup
YS
Chun
Jong Woon
JW
Chung
Jin Tae
JT
You
Sung Soo
SS
Ha
Hyung Keun
HK
Lee
Chang Hyeong
CH
Kim
Ho Gak
HG
Cho
Chang Ho
CH
D000328:Adult; D000368:Aged; D001706:Biopsy; D003937:Diagnosis, Differential; D019160:Endosonography; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D046152:Gastrointestinal Stromal Tumors / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007890:Leiomyosarcoma / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged