title: Endosonographic features of histologically proven gastric ectopic pancreas.
abstract: Gastric ectopic pancreas is an uncommon developmental anomaly and its histological diagnosis is usually difficult by using a conventional biopsy forceps. In the literature, most cases of gastric ectopic pancreas were usually diagnosed by gross pattern during endoscopic examination or features of endoscopic ultrasound. In contrast, this disease was seldom diagnosed by histology in clinical practice. Although the typical endoscopic ultrasonographic features of ectopic pancreas include heterogeneous echogenicity, indistinct borders, and a location within 2 or more layers, it can also exhibit hypoechoic homogeneous echogenicity and a distinct border within the fourth sonographic layer (muscularis propria) similar to the endoscopic ultrasonographic features of gastrointestinal stromal tumors. In our study, we found that 53% of gastric ectopic pancreas originated within the fourth sonographic layer, demonstrating hypoechoic, homogeneous echogenicity, and distinct borders. Therefore, recognizing endoscopic ultrasonographic features, combining with deep biopsy, endoscopic ultrasound-guided fine needle aspiration/core needle biopsy can prevent conducting unnecessary resection. Surgical resection is the mainstay treatment for symptomatic gastric ectopic pancreas, but endoscopic resection using endoscopic mucosal resection or endoscopic submucosal dissection technique provides an alternative method of removing superficial-type and deep-type gastric ectopic pancreas.
authors.affiliation: School of Medicine, China Medical University, Taichung 40447, Taiwan ; Division of Gastroenterology and Hepatology, Department of Internal Medicine, China Medical University Hospital, No. 2, Yude Road, North District, Taichung 40447, Taiwan.
authors.forename: Jen-Wei
authors.identifier: 0000-0002-4674-6487
authors.initials: JW
authors.lastname: Chou
authors.affiliation: School of Medicine, China Medical University, Taichung 40447, Taiwan ; Division of Gastroenterology and Hepatology, Department of Internal Medicine, China Medical University Hospital, No. 2, Yude Road, North District, Taichung 40447, Taiwan.
authors.forename: Ken-Sheng
authors.initials: KS
authors.lastname: Cheng
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, China Medical University Hospital, No. 2, Yude Road, North District, Taichung 40447, Taiwan.
authors.forename: Chun-Fu
authors.initials: CF
authors.lastname: Ting
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, China Medical University Hospital, No. 2, Yude Road, North District, Taichung 40447, Taiwan.
authors.forename: Chun-Lung
authors.initials: CL
authors.lastname: Feng
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, China Medical University Hospital, No. 2, Yude Road, North District, Taichung 40447, Taiwan.
authors.forename: Yu-Ta
authors.identifier: 0000-0001-8776-0405
authors.initials: YT
authors.lastname: Lin
authors.affiliation: School of Medicine, China Medical University, Taichung 40447, Taiwan ; Division of Gastroenterology and Hepatology, Department of Internal Medicine, China Medical University Hospital, No. 2, Yude Road, North District, Taichung 40447, Taiwan.
authors.forename: Wen-Hsin
authors.initials: WH
authors.lastname: Huang