AIM:To determine if there is consistency between endoscopic ultrasound(EUS)findings and pathological results for detecting lesions of different depth in the esophageal mucosa.METHODS:A canine(Beagle)model was establis...AIM:To determine if there is consistency between endoscopic ultrasound(EUS)findings and pathological results for detecting lesions of different depth in the esophageal mucosa.METHODS:A canine(Beagle)model was established in which lesions of different depths were created in the esophageal mucosa by thermal burning.Seventy-two hours later,these lesions and adjacent tissue in the esophagus were examined by EUS.EUS findings including infiltrating depth,strength of echogenicity and homogeneity were recorded.Dogs were sacrificed and tissue specimens were obtained.We then compared the EUS findings with the pathology reports.RESULTS:Thermal burns created at different power settings caused lesions of different depth in the esophageal mucosa.When the echo strength was shifted from high,medium,to low echogenicity,an increase in the infiltrating depth of the lesion was noted,which coincided with results of the pathology examination.Obvious submucosal edema visualized by EUS was also detected by pathology.Furthermore,because of the enhancement caused by the submucosal edema,the lesions invading into the submucosa were easily visualized by EUS.CONCLUSION:There is consistency between EUS findings and pathological results of esophageal lesions with different depths.Submucosal edema can serve as an ultrasonic contrast agent.展开更多
Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) is a useful procedure that enables reliable pathological diagnoses of pancreatobiliary diseases, subepithelial lesions, and swollen lymph nodes. In ...Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) is a useful procedure that enables reliable pathological diagnoses of pancreatobiliary diseases, subepithelial lesions, and swollen lymph nodes. In recent years, a pathological diagnosis based on EUS-FNA has made it possible to provide accurate treatment methods not only in these fields, but also in respiratory organs and otorhinolaryngology. This review discusses the latest topics pertaining to EUS-FNA as well as procedural tips.展开更多
BACKGROUND Oesophageal cancer is the fourth most common cause of cancer-related deaths in India.Esophageal squamous cell carcinomas(ESCCs)arise from the epithelial layer,and commonly present as polypoidal,ulcerative o...BACKGROUND Oesophageal cancer is the fourth most common cause of cancer-related deaths in India.Esophageal squamous cell carcinomas(ESCCs)arise from the epithelial layer,and commonly present as polypoidal,ulcerative or ulceroproliferative growth in the oesophageal lumen.In contrast,oesophageal submucosal tumours are a distinct group of tumours arising from the mesenchyme(examples include leiomyoma,fibrovasculoma,lipoma,granular cell tumour or carcinoid),and mostly do not breach the mucosa.Oesophageal submucosal tumours are a distinct group of tumours arising from the mesenchyme,and mostly do not breach the mucosa.Complete intramural growth of an advanced primary ESCC is an exceedingly rare presentation,with only six cases reported in the literature thus far.We herein report a case of primary ESCC with complete intramural invasion that endoscopically mimics a submucosal lesion.CASE SUMMARY A 50 year old male presented with a progressive mechanical type of dysphagia for one month.His history was significant,including squamous cell carcinoma of the tongue that was treated with surgery and chemoradiation 1 year prior.Upper gastrointestinal endoscopy revealed a large,hemispherical lesion with normalappearing overlying mucosa about 4 cm×5 cm in size extending from 30-34 cm from incisors.The patient underwent endoscopic ultrasound(EUS),and a fineneedle biopsy was performed,which was suggestive for squamous cell carcinoma.We herein report a case of primary ESCC with complete intramural invasion,endoscopically mimicking a submucosal lesion.The diagnosis could be established only by a EUS-guided biopsy.CONCLUSION This case report highlights that intramural ESCC may look like a submucosal lesion in endoscopy,and EUS biopsy is needed for final diagnosis.展开更多
基金Supported by The Science and Technology Plan Projects of Guangdong Province,China,No.2011B080701015 and No.2012B061700076
文摘AIM:To determine if there is consistency between endoscopic ultrasound(EUS)findings and pathological results for detecting lesions of different depth in the esophageal mucosa.METHODS:A canine(Beagle)model was established in which lesions of different depths were created in the esophageal mucosa by thermal burning.Seventy-two hours later,these lesions and adjacent tissue in the esophagus were examined by EUS.EUS findings including infiltrating depth,strength of echogenicity and homogeneity were recorded.Dogs were sacrificed and tissue specimens were obtained.We then compared the EUS findings with the pathology reports.RESULTS:Thermal burns created at different power settings caused lesions of different depth in the esophageal mucosa.When the echo strength was shifted from high,medium,to low echogenicity,an increase in the infiltrating depth of the lesion was noted,which coincided with results of the pathology examination.Obvious submucosal edema visualized by EUS was also detected by pathology.Furthermore,because of the enhancement caused by the submucosal edema,the lesions invading into the submucosa were easily visualized by EUS.CONCLUSION:There is consistency between EUS findings and pathological results of esophageal lesions with different depths.Submucosal edema can serve as an ultrasonic contrast agent.
文摘Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNA) is a useful procedure that enables reliable pathological diagnoses of pancreatobiliary diseases, subepithelial lesions, and swollen lymph nodes. In recent years, a pathological diagnosis based on EUS-FNA has made it possible to provide accurate treatment methods not only in these fields, but also in respiratory organs and otorhinolaryngology. This review discusses the latest topics pertaining to EUS-FNA as well as procedural tips.
文摘BACKGROUND Oesophageal cancer is the fourth most common cause of cancer-related deaths in India.Esophageal squamous cell carcinomas(ESCCs)arise from the epithelial layer,and commonly present as polypoidal,ulcerative or ulceroproliferative growth in the oesophageal lumen.In contrast,oesophageal submucosal tumours are a distinct group of tumours arising from the mesenchyme(examples include leiomyoma,fibrovasculoma,lipoma,granular cell tumour or carcinoid),and mostly do not breach the mucosa.Oesophageal submucosal tumours are a distinct group of tumours arising from the mesenchyme,and mostly do not breach the mucosa.Complete intramural growth of an advanced primary ESCC is an exceedingly rare presentation,with only six cases reported in the literature thus far.We herein report a case of primary ESCC with complete intramural invasion that endoscopically mimics a submucosal lesion.CASE SUMMARY A 50 year old male presented with a progressive mechanical type of dysphagia for one month.His history was significant,including squamous cell carcinoma of the tongue that was treated with surgery and chemoradiation 1 year prior.Upper gastrointestinal endoscopy revealed a large,hemispherical lesion with normalappearing overlying mucosa about 4 cm×5 cm in size extending from 30-34 cm from incisors.The patient underwent endoscopic ultrasound(EUS),and a fineneedle biopsy was performed,which was suggestive for squamous cell carcinoma.We herein report a case of primary ESCC with complete intramural invasion,endoscopically mimicking a submucosal lesion.The diagnosis could be established only by a EUS-guided biopsy.CONCLUSION This case report highlights that intramural ESCC may look like a submucosal lesion in endoscopy,and EUS biopsy is needed for final diagnosis.
