The Role of Endoscopic Ultrasonography (EUS) in Diagnosis of Gastric masses.

Abstract

Background: The diagnosis of different gastric lesions as masses, ulcers and hypertrophic gastric folds by upper endoscopy and radiological modalities is sometimes difficult. Conventional endoscopic biopsies are frequently not diagnostic as the biopsy forceps do not reach the tumors located deeper than the mucosal layer as Leiomyoma, Leiomyosarcoma, lymphoma and diffuse type of adenocarcinoma. Aim of work: The aim of the present work is to evaluate the role of endoscopic ultrasonography in the diagnosis of biopsy negative gastric lesions. Patients and Methods: This work included 30 patients with gastric lesions, 19 (63.33%) patients with gastric masses, 5 (16:67%) patients with hypertrophic gastric folds, 4 (I 3.33%) patients with gastric ulcers and 2 (6.67%) patients with nodular mucosa. Conventional biopsies using standard biopsy forceps were non specific in all lesions. Then, all patients were subjected for endoscopic ultrasonography. Other modalities of tissue biopsy as sonar guided truecut biopsy, large particle biopsy, diathermy snare biopsy and surgical excisional biopsy were done to obtain enough samples for final histopathological diagnosis. Then• correlation between endoscopic ultrasonographic diagnosis and histopathologic diagnosis was done. Results: Endoscopic ultrasonography could correctly diagnose 27 out of 30 (90%) cases. Only one case of adenocarcinoma was diagnosed as lymphoma and 2 cases of Leiomyosarcomas were diagnosed as Leiomyomas. Conclusion: We conclude that endoscopic ultrasonography is very valuable in the diagnostic work up of cases with suspicious gastric lesions when conventional endoscopic biopsies are inconclusive.

Kevwords: EUS- Gastric Mass- Endoscopic Ultrasonography- Biopsy

Negative.