title: Duodenal subepithelial hyperechoic lesions of the third layer: Not always a lipoma.
abstract: Endoscopic ultrasonography is the most accurate procedure for the evaluation of subepithelial lesions. The finding of a homogeneous, hyperechoic, well-delimited lesion, originating from the third layer of the gastrointestinal tract (submucosa) suggests a benign tumor, generally lipoma. As other differential diagnoses have not been reported, echoendoscopists might not pursue a definitive pathological diagnosis or follow-up the patient. This case series aims to broaden the spectrum of differential diagnosis for duodenal hyperechoic third layer subepithelial lesions by providing four different and relevant pathologies with this echoendoscopic pattern.
authors.affiliation: Pedro C Figueiredo, Pedro Pinto-Marques, Gastroenterology Department, Hospital Garcia de Orta, Avenida Torrado da Silva, 2801-951 Almada, Portugal.
authors.forename: Pedro C
authors.initials: PC
authors.lastname: Figueiredo
authors.forename: Pedro
authors.initials: P
authors.lastname: Pinto-Marques
authors.forename: Evelina
authors.initials: E
authors.lastname: Mendonça
authors.forename: Pedro
authors.initials: P
authors.lastname: Oliveira
authors.forename: Maria
authors.initials: M
authors.lastname: Brito
authors.forename: David
authors.initials: D
authors.lastname: Serra
keywords: Duodenum; Endoscopic ultrasonography; Endoscopic ultrasound-guided fine needle aspiration; Lipoma; Subepithelial tumor