+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Endoscopic ultrasonography in the differential diagnosis of giant gastric folds



Endoscopic ultrasonography in the differential diagnosis of giant gastric folds



Journal of the Formosan Medical Association 98(4): 261-264



Giant gastric folds (or large gastric folds) are found in both benign and malignant diseases, and differential diagnosis with either upper gastrointestinal X-ray or endoscopy is difficult. Sometimes, even endoscopic biopsy cannot establish a definitive diagnosis. Recently, endoscopic ultrasonography (EUS) has been used to study giant gastric folds. We performed EUS in 25 patients with giant gastric folds that had been detected with upper gastrointestinal X-ray or endoscopy. The definitive diagnoses were confirmed by histopathology, other examinations, or long-term follow-up. The final diagnoses of these 25 patients were gastric varices in eight, gastric lymphangiectasis in one, gastritis in four, gastric carcinoma (scirrhous type) in six, and gastric lymphomas in six. All patients with gastric varices had anechoic tortuous varicose veins in the submucosal layer. EUS images of gastric lymphangiectasis were similar to those of gastric varices. EUS revealed regular gastric wall thickening of the second (mucosa) and third (submucosa) layers in all cases of gastritis. The fourth (muscularis propria) layer was intact in the only case of mucosa-associated lymphoid tissue lymphoma (MALToma), but not in the other five cases of gastric lymphoma. The second and third layers of this MALToma were irregular in thickness and heterogenous in echogenicity, different from the characteristic EUS findings in gastritis. The fourth layer was markedly thickened only in malignant conditions. Differentiation of gastric cancer from lymphoma with EUS was difficult because of overlapping EUS findings. In conclusion, EUS is indicated for the differential diagnosis of giant gastric folds. In addition, it avoids the risk associated with biopsy of gastric varices.

(PDF emailed within 1 workday: $29.90)

Accession: 010585426

Download citation: RISBibTeXText

PMID: 10389370


Related references

Endoscopic differential diagnosis of giant folds. Stomach & Intestine (Tokyo) 15(5): 509-518, 1980

Gastritis cystica profunda presenting as giant gastric mucosal folds: the role of endoscopic ultrasonography and mucosectomy in the diagnostic work-up. Gastrointestinal Endoscopy 40(5): 640-644, 1994

Giant gastric folds: differential diagnosis at US. Radiology 226(3): 686-690, 2003

MDCT of giant gastric folds: differential diagnosis. Ajr. American Journal of Roentgenology 195(5): 1124-1130, 2010

Endoscopic ultrasonography in the diagnosis and follow-up of patients with thickened gastric folds, active gastritis and Helicobacter pylori infection before and after eradication. American Journal of Gastroenterology 89(8): 1363, 1994

Giant abdominal stromal cell tumour diagnosed at endoscopic ultrasonography: Is there a need for systematic use of endoscopic ultrasonography in submucosal gastric tumours?. Digestive & Liver Disease 34(4): 302-305, April, 2002

The role of endoscopic ultrasonography in the differential diagnosis of gastric excavated lesions. Journal of Cancer Research & Clinical Oncology 116(SUPPL PART 1): 129, 1990

Endoscopic ultrasonography in large gastric folds. Endoscopy 30 Suppl 1: A72-A75, 1998

Large gastric folds evaluated by endoscopic ultrasonography. Gastrointestinal Endoscopy Clinics of North America 5(3): 683-691, 1995

Clinical evaluation of endoscopic ultrasonography on differential diagnosis of malignancy in gastric myogenic tumors. Gastroenterological Endoscopy 32(11): 2562-2569, 1990

Large gastric folds: a diagnostic approach using endoscopic ultrasonography. Gastrointestinal Endoscopy 40(4): 437-441, 1994

Accuracy of a scoring system for the differential diagnosis of common gastric subepithelial tumors based on endoscopic ultrasonography. Journal of Digestive Diseases 14(12): 647-653, 2014

Quantitative diagnosis of endoscopic ultrasonography by texture analysis 2nd report quantitative differential diagnosis of gastric submucosal tumors. Gastroenterological Endoscopy 33(2): 235-242, 1991

Selective Endoscopic Gastrobiopsy In Giant Folds Of The Gastric Mucosa. Deutsche Medizinische Wochenschrift 90: 1510-1515, 1965