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Subepithelial lesions

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Hakan Senturk
Hakan Senturk

Endoscopic ultrasonography of subepithelial lesions.

Health & Medicine
1 of 30
SUBMUCOSAL LESIONS EUS and EUS-FNA Hakan Senturk, MD Professor of Medicine, Chief of Gastroenterology Division Faculty of Medicine Bezmialem Vakif University
SUBEPITHELIAL LESION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Hedenbro JL Surg Endosc. 1991;5:20-3.
Duodenum Esophagus Stomach
Esophagus Mide Stomach Stomach
 
 
 
 
EUS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
1 Irregular border , , echogenic foci, anechoic areas are in favour of malignancy Etiology EUS -layer EUS –appearance GIST 2,4 Hypoechoic 1 Ectopic pancreas 2, 3, and/or 4 Hypoechoic/mixt Lipoma 3 Hyperechoic Carcinoid 2 and/or 3 Mild hypoechoic, homogenous Cyst 3 Anechoic
External compression-Esophagus ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
External compression – Stomach ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
GIST ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
GIST-2 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Ectopic Pancreas ,[object Object],[object Object],[object Object],[object Object]
 
Lipoma ,[object Object],[object Object],[object Object],[object Object]
 
Neuroendocrine tumors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
Method ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Results ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
N % Location Esophagus 23 31 Stomach 48 65 Duodenum 2 2.7 EUS echogenicity Hypoechoic 42 57 Hyperechoic 8 10.9 Hypoechoic + echogenic focus 23 32 Origin Mucosa 14 19 Muscularis mucosa 8 10 Submucosa 7 9 Muscularis propria 40 54 Extramural 4 5 Diameter <2.5 25 34 2.5-5 40 54 ,[object Object],8 11
EUS-FNA results GIST 19 (26%) Leomyoma 17 (23.3%) Esophageal cancer 7 ( 9.6%) Gastric cancer 4 (5.5%) Metastatic M. Melanoma 1 (1.4%) Lung cancer 1 (1.4%) MALT lymphoma 1 (1.4%) Granular cell tumor 1 (1.4%) Hyperplastic polyp 1 (1.4%)
EUS preliminary diagnosis Final diagnosis GIST 29 23 Leomyoma 19 22 Esophageal cancer 6 8 Lung cancer 1 1 Gastric cancer 6 6 MALT lymphoma 0 1 Duplication cyst 4 4 Ectopic pancreas 0 2 Lipoma 2 2 Fibroma 2 0 Hyperplastic polyp 1 1 Granular cell tumor 1 1 73 73
EUS-FNA diagnosis Final diagnosis GIST 19 21 Leomyoma 17 22 Esophageal cancer 7 8 Lung cancer 1 1 Gastric cancer 4 5 MALT lypmhoma 1 1 Duplication cyst 4 4 Ectopic pancreas 0 2 Hyperplastic polyp 1 1 Granular cell tumor 1 1 Lypmh node 2 Metastasis of M. Melanoma Langerhans c. Histiocytosis Inadequate 12 68 68
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Subepithelial lesions

  • 1. SUBMUCOSAL LESIONS EUS and EUS-FNA Hakan Senturk, MD Professor of Medicine, Chief of Gastroenterology Division Faculty of Medicine Bezmialem Vakif University
  • 2.
  • 3. Duodenum Esophagus Stomach
  • 4. Esophagus Mide Stomach Stomach
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  • 12. 1 Irregular border , , echogenic foci, anechoic areas are in favour of malignancy Etiology EUS -layer EUS –appearance GIST 2,4 Hypoechoic 1 Ectopic pancreas 2, 3, and/or 4 Hypoechoic/mixt Lipoma 3 Hyperechoic Carcinoid 2 and/or 3 Mild hypoechoic, homogenous Cyst 3 Anechoic
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  • 27. EUS-FNA results GIST 19 (26%) Leomyoma 17 (23.3%) Esophageal cancer 7 ( 9.6%) Gastric cancer 4 (5.5%) Metastatic M. Melanoma 1 (1.4%) Lung cancer 1 (1.4%) MALT lymphoma 1 (1.4%) Granular cell tumor 1 (1.4%) Hyperplastic polyp 1 (1.4%)
  • 28. EUS preliminary diagnosis Final diagnosis GIST 29 23 Leomyoma 19 22 Esophageal cancer 6 8 Lung cancer 1 1 Gastric cancer 6 6 MALT lymphoma 0 1 Duplication cyst 4 4 Ectopic pancreas 0 2 Lipoma 2 2 Fibroma 2 0 Hyperplastic polyp 1 1 Granular cell tumor 1 1 73 73
  • 29. EUS-FNA diagnosis Final diagnosis GIST 19 21 Leomyoma 17 22 Esophageal cancer 7 8 Lung cancer 1 1 Gastric cancer 4 5 MALT lypmhoma 1 1 Duplication cyst 4 4 Ectopic pancreas 0 2 Hyperplastic polyp 1 1 Granular cell tumor 1 1 Lypmh node 2 Metastasis of M. Melanoma Langerhans c. Histiocytosis Inadequate 12 68 68
  • 30.