Endosonographic features of gastric ectopic pancreases distinguishable from mesenchymal tumors.
OBJECTIVE
Gastric ectopic pancreas is the second common submucosal lesion in the stomach, and differs from mesenchymal tumors with respect to clinical approach and prognosis. The purpose of our study was to evaluate the endoscopic ultrasound (EUS) findings for differentiating between gastric ectopic pancreases and mesenchymal tumors.


METHODS
All patients (n = 71) were diagnosed pathologically as having gastric ectopic pancreas (n = 18) or mesenchymal tumors (n = 53) between 2002 and 2006. The EUS images of the patients were retrospectively reviewed by two observers who were unaware of the pathological results, regarding location, size, growth pattern, layer of origin, presence or absence of layer disruption, margin, and internal echo pattern. These EUS imaging findings were compared for ectopic pancreases and mesenchymal tumors.


RESULTS
Compared with mesenchymal tumors, ectopic pancreases showed a significant difference in the lesion location, growth pattern, layer of origin, presence of layer disruption, margin, and internal echo (P < 0.05). The longest/shortest diameter ratio was also larger in ectopic pancreases (p < 0.05). There was no statistical difference in the lesion size and presence of focal anechoic portion.


CONCLUSIONS
Careful assessment of the EUS findings may be a useful aid in the differentiation of ectopic pancreases from mesenchymal tumors in the stomach.
Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of medicine, Seoul, Korea.
Jie-Hyun
JH
Kim
Joon Seok
JS
Lim
Yong Chan
YC
Lee
Woo Jin
WJ
Hyung
Jei Hee
JH
Lee
Myeong-Jin
MJ
Kim
Jae Bock
JB
Chung
D000328:Adult; D002828:Choristoma / Q000000981:diagnostic imaging*; D019160:Endosonography; D005260:Female; D006801:Humans; D008297:Male; D008648:Mesoderm; D008875:Middle Aged; D010179:Pancreas; D012983:Soft Tissue Neoplasms / Q000000981:diagnostic imaging*; D013272:Stomach Diseases / Q000000981:diagnostic imaging*; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging