title: Histological diagnosis of gastric submucosal tumors: A pilot study of endoscopic ultrasonography-guided fine-needle aspiration biopsy vs mucosal cutting biopsy.
abstract: OBJECTIVE
  To compare the usefulness of endoscopic ultrasonography-guided fine-needle aspiration biopsy (EUS-FNAB) without cytology and mucosal cutting biopsy (MCB) in the histological diagnosis of gastric submucosal tumor (SMT).
  
  
  METHODS
  We prospectively compared the diagnostic yield, feasibility, and safety of EUS-FNAB and those of MCB based on endoscopic submucosal dissection. The cases of 20 consecutive patients with gastric SMT ≥ 1 cm in diameter. who underwent both EUS-FNAB and MCB were investigated.
  
  
  RESULTS
  The histological diagnoses were gastrointestinal stromal tumors (n = 7), leiomyoma (n = 6), schwannoma (n = 2), aberrant pancreas (n = 2), and one case each of glomus tumor, metastatic hepatocellular carcinoma, and no-diagnosis. The tumors' mean size was 23.6 mm. Histological diagnosis was made in 65.0% of the EUS-FNABs and 60.0% of the MCBs, a nonsignificant difference. There were no significant differences in the diagnostic yield concerning the tumor location or tumor size between the two methods. However, diagnostic specimens were significantly more frequently obtained in lesions with intraluminal growth than in those with extraluminal growth by the MCB method (P = 0.01). All four SMTs with extraluminal growth were diagnosed only by EUS-FNAB (P = 0.03). No complications were found in either method.
  
  
  CONCLUSIONS
  MCB may be chosen as an alternative diagnostic modality in tumors showing the intraluminal growth pattern regardless of tumor size, whereas EUS-FNAB should be performed for SMTs with extraluminal growth.
authors.affiliation: Hisatomo Ikehara, Zhaoliang Li, Jiro Watari, Masato Taki, Tomohiro Ogawa, Takahisa Yamasaki, Takashi Kondo, Fumihiko Toyoshima, Tomoaki Kono, Katsuyuki Tozawa, Yoshio Ohda, Toshihiko Tomita, Tadayuki Oshima, Hirokazu Fukui, Hiroto Miwa, Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
authors.forename: Hisatomo
authors.initials: H
authors.lastname: Ikehara
authors.affiliation: Hisatomo Ikehara, Zhaoliang Li, Jiro Watari, Masato Taki, Tomohiro Ogawa, Takahisa Yamasaki, Takashi Kondo, Fumihiko Toyoshima, Tomoaki Kono, Katsuyuki Tozawa, Yoshio Ohda, Toshihiko Tomita, Tadayuki Oshima, Hirokazu Fukui, Hiroto Miwa, Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
authors.forename: Zhaoliang
authors.initials: Z
authors.lastname: Li
authors.affiliation: Hisatomo Ikehara, Zhaoliang Li, Jiro Watari, Masato Taki, Tomohiro Ogawa, Takahisa Yamasaki, Takashi Kondo, Fumihiko Toyoshima, Tomoaki Kono, Katsuyuki Tozawa, Yoshio Ohda, Toshihiko Tomita, Tadayuki Oshima, Hirokazu Fukui, Hiroto Miwa, Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
authors.forename: Jiro
authors.initials: J
authors.lastname: Watari
authors.affiliation: Hisatomo Ikehara, Zhaoliang Li, Jiro Watari, Masato Taki, Tomohiro Ogawa, Takahisa Yamasaki, Takashi Kondo, Fumihiko Toyoshima, Tomoaki Kono, Katsuyuki Tozawa, Yoshio Ohda, Toshihiko Tomita, Tadayuki Oshima, Hirokazu Fukui, Hiroto Miwa, Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Taki
authors.affiliation: Hisatomo Ikehara, Zhaoliang Li, Jiro Watari, Masato Taki, Tomohiro Ogawa, Takahisa Yamasaki, Takashi Kondo, Fumihiko Toyoshima, Tomoaki Kono, Katsuyuki Tozawa, Yoshio Ohda, Toshihiko Tomita, Tadayuki Oshima, Hirokazu Fukui, Hiroto Miwa, Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Ogawa
authors.affiliation: Hisatomo Ikehara, Zhaoliang Li, Jiro Watari, Masato Taki, Tomohiro Ogawa, Takahisa Yamasaki, Takashi Kondo, Fumihiko Toyoshima, Tomoaki Kono, Katsuyuki Tozawa, Yoshio Ohda, Toshihiko Tomita, Tadayuki Oshima, Hirokazu Fukui, Hiroto Miwa, Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
authors.forename: Takahisa
authors.initials: T
authors.lastname: Yamasaki
authors.affiliation: Hisatomo Ikehara, Zhaoliang Li, Jiro Watari, Masato Taki, Tomohiro Ogawa, Takahisa Yamasaki, Takashi Kondo, Fumihiko Toyoshima, Tomoaki Kono, Katsuyuki Tozawa, Yoshio Ohda, Toshihiko Tomita, Tadayuki Oshima, Hirokazu Fukui, Hiroto Miwa, Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kondo
authors.affiliation: Hisatomo Ikehara, Zhaoliang Li, Jiro Watari, Masato Taki, Tomohiro Ogawa, Takahisa Yamasaki, Takashi Kondo, Fumihiko Toyoshima, Tomoaki Kono, Katsuyuki Tozawa, Yoshio Ohda, Toshihiko Tomita, Tadayuki Oshima, Hirokazu Fukui, Hiroto Miwa, Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Toyoshima
authors.affiliation: Hisatomo Ikehara, Zhaoliang Li, Jiro Watari, Masato Taki, Tomohiro Ogawa, Takahisa Yamasaki, Takashi Kondo, Fumihiko Toyoshima, Tomoaki Kono, Katsuyuki Tozawa, Yoshio Ohda, Toshihiko Tomita, Tadayuki Oshima, Hirokazu Fukui, Hiroto Miwa, Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Kono
authors.affiliation: Hisatomo Ikehara, Zhaoliang Li, Jiro Watari, Masato Taki, Tomohiro Ogawa, Takahisa Yamasaki, Takashi Kondo, Fumihiko Toyoshima, Tomoaki Kono, Katsuyuki Tozawa, Yoshio Ohda, Toshihiko Tomita, Tadayuki Oshima, Hirokazu Fukui, Hiroto Miwa, Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Tozawa
authors.affiliation: Hisatomo Ikehara, Zhaoliang Li, Jiro Watari, Masato Taki, Tomohiro Ogawa, Takahisa Yamasaki, Takashi Kondo, Fumihiko Toyoshima, Tomoaki Kono, Katsuyuki Tozawa, Yoshio Ohda, Toshihiko Tomita, Tadayuki Oshima, Hirokazu Fukui, Hiroto Miwa, Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Ohda
authors.affiliation: Hisatomo Ikehara, Zhaoliang Li, Jiro Watari, Masato Taki, Tomohiro Ogawa, Takahisa Yamasaki, Takashi Kondo, Fumihiko Toyoshima, Tomoaki Kono, Katsuyuki Tozawa, Yoshio Ohda, Toshihiko Tomita, Tadayuki Oshima, Hirokazu Fukui, Hiroto Miwa, Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Tomita
authors.affiliation: Hisatomo Ikehara, Zhaoliang Li, Jiro Watari, Masato Taki, Tomohiro Ogawa, Takahisa Yamasaki, Takashi Kondo, Fumihiko Toyoshima, Tomoaki Kono, Katsuyuki Tozawa, Yoshio Ohda, Toshihiko Tomita, Tadayuki Oshima, Hirokazu Fukui, Hiroto Miwa, Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Oshima
authors.affiliation: Hisatomo Ikehara, Zhaoliang Li, Jiro Watari, Masato Taki, Tomohiro Ogawa, Takahisa Yamasaki, Takashi Kondo, Fumihiko Toyoshima, Tomoaki Kono, Katsuyuki Tozawa, Yoshio Ohda, Toshihiko Tomita, Tadayuki Oshima, Hirokazu Fukui, Hiroto Miwa, Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Fukui
authors.affiliation: Hisatomo Ikehara, Zhaoliang Li, Jiro Watari, Masato Taki, Tomohiro Ogawa, Takahisa Yamasaki, Takashi Kondo, Fumihiko Toyoshima, Tomoaki Kono, Katsuyuki Tozawa, Yoshio Ohda, Toshihiko Tomita, Tadayuki Oshima, Hirokazu Fukui, Hiroto Miwa, Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
authors.forename: Ikuo
authors.initials: I
authors.lastname: Matsuda
authors.affiliation: Hisatomo Ikehara, Zhaoliang Li, Jiro Watari, Masato Taki, Tomohiro Ogawa, Takahisa Yamasaki, Takashi Kondo, Fumihiko Toyoshima, Tomoaki Kono, Katsuyuki Tozawa, Yoshio Ohda, Toshihiko Tomita, Tadayuki Oshima, Hirokazu Fukui, Hiroto Miwa, Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
authors.forename: Seiichi
authors.initials: S
authors.lastname: Hirota
authors.affiliation: Hisatomo Ikehara, Zhaoliang Li, Jiro Watari, Masato Taki, Tomohiro Ogawa, Takahisa Yamasaki, Takashi Kondo, Fumihiko Toyoshima, Tomoaki Kono, Katsuyuki Tozawa, Yoshio Ohda, Toshihiko Tomita, Tadayuki Oshima, Hirokazu Fukui, Hiroto Miwa, Division of Gastroenterology, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Hyogo 663-8501, Japan.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Miwa
keywords: Endoscopic submucosal dissection; Endoscopic ultrasonography-guided fine-needle aspiration biopsy; Gastrointestinal stromal tumor; Mucosal cutting biopsy; Submucosal tumor