A feasible modified biopsy method for tissue diagnosis of gastric subepithelial tumors.
OBJECTIVE
To evaluate the diagnostic yield and safety of a modified technique for the histological diagnosis of subepithelial tumors (SETs).


METHODS
A retrospective review of patients who underwent a modified technique for the histological diagnosis of gastric SETs, consisting of a mucosal incision with a fixed flexible snare (MIF) and deep-tissue biopsy under conventional endoscopic view, from January 2012 to January 2013 was performed. Eleven patients with gastric SETs 10-30 mm in diameter and originating from the third or fourth layer on endoscopic ultrasonography were included.


RESULTS
The mean age was 59.8 (range, 45-76) years, and 5 patients were male. The mean size of the SETs was 21.8 (range, 11-30) mm. The number of biopsy specimens was 6.3 (range 5-8). The mean procedure time was 9.0 min (range, 4-17 min). The diagnostic yield of MIF biopsies was 90.9% (10/11). The histological diagnoses were leiomyoma (4/11, 36.4%), aberrant pancreas (3/11, 27.3%), gastrointestinal stromal tumors (2/11, 18.2%), an inflammatory fibrinoid tumor (1/11, 9.1%); one result was non-diagnostic (1/11, 9.1%). There were six mesenchymal tumors; the specimens obtained in each case were sufficient for an immunohistochemical diagnosis. There was no major bleeding, but one perforation occurred that was successfully controlled by endoscopic clipping.


CONCLUSIONS
The MIF biopsy was simple to perform, safe, and required a shorter procedure time, with a high diagnostic yield for small SETs.
Department of Internal Medicine, Gachon University Gil Medical Center, Incheon 405-760, South Korea.
Jung Ho
JH
Kim
Jun-Won
JW
Chung
Minsu
M
Ha
Min Young
MY
Rim
Jong Joon
JJ
Lee
Jungsuk
J
An
Yoon Jae
YJ
Kim
Kyoung Oh
KO
Kim
Kwang An
KA
Kwon
Dong Kyun
DK
Park
Yeon Suk
YS
Kim
Duck Joo
DJ
Choi
D000368:Aged; D019160:Endosonography; D005240:Feasibility Studies; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D005773:Gastroscopy / Q000009:adverse effects; D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology*; D013997:Time Factors; D047368:Tumor Burden
Biopsy; Diagnostic techniques; Endoscopy; Stomach; Subepithelial tumors