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Subepithelial tumor

Nishitha Thumallapally, Uroosa Ibrahim, Mayurathan Kesavan, Qing Chang, Lynne Opitz, Meekoo Dhar, Sherif Andrawes
Granular cell tumors (GCTs) are soft tissue neoplasms that originate from Schwann cells. They occur predominantly in the oral cavity, skin, and breast tissues. Gastrointestinal GCTs are very rare, accounting for only eight percent of all GCTs, most of which are located in the esophagus. Endoscopic ultrasound has been a breakthrough in diagnosing GCTs because it provides precise information on the depth of tumor invasion, thus narrowing the differential diagnosis of subepithelial lesions in the esophagus. However, the definitive diagnosis requires histological confirmation of the lesion...
September 14, 2016: Curēus
Eun Jeong Gong, Do Hoon Kim
Subepithelial lesions occasionally found in the stomach of patients undergoing endoscopy may be either benign lesions or tumors with malignant potential. They may also appear due to extrinsic compression. Discrimination of gastric subepithelial lesions begins with meticulous endoscopic examination for size, shape, color, mobility, consistency, and appearance of the overlying mucosa. Accurate diagnosis can be achieved with endoscopic ultrasonography, which provides useful information on the exact size, layer-of-origin, and characteristic morphologic features to support a definitive diagnosis...
September 2016: Clinical Endoscopy
Yoon Suk Jung, Hyuk Lee, Kyungeun Kim, Jin Hee Sohn, Hong Joo Kim, Jung Ho Park
The current tissue sampling techniques for subepithelial tumors (SETs) of the gastrointestinal (GI) tract have limited diagnostic efficacy. We evaluated the diagnostic yield and safety of forceps biopsies after small endoscopic submucosal dissection (SESD biopsies) in the diagnosis of gastric SETs. A total of 42 patients with gastric SETs > 10 mm were prospectively enrolled between May 2013 and October 2014. A dual knife was used to incise the mucosa and submucosa and forceps biopsies were then introduced deep into the lesion...
November 2016: Journal of Korean Medical Science
Xin-Li Mao, Li-Ping Ye, Hai-Hong Zheng, Xian-Bin Zhou, Lin-Hong Zhu, Yu Zhang
Submucosal tunneling endoscopic resection (STER) of subepithelial tumors (SETs) originating from the muscularis propria (MP) layer in the cardia is rarely performed due to the difficulty of creating a submucosal tunnel for resection. The aim of this study was to evaluate the feasibility of STER using methylene-blue guidance for SETs originating from the MP layer in the cardia. From January 2012 to December 2014, 56 patients with SETs originating from the MP layer in the cardia were treated with STER using methylene-blue guidance...
September 26, 2016: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Jun-Ichiro Ikeda, Masaharu Kohara, Yoko Tsuruta, Satoshi Nojima, Shinichiro Tahara, Kenji Ohshima, Masako Kurashige, Naoki Wada, Eiichi Morii
Marginal zone lymphoma (MZL) is a low-grade B-cell lymphoma derived from marginal-zone B cells. Because of a lack of specific immunohistochemical markers, MZL is mainly diagnosed based on the cytological appearance and growth pattern of the tumor. Marginal-zone B cells were recently shown to selectively express immunoglobulin superfamily receptor translocation-associated 1 (IRTA1), but the antibody used in that study is not commercially available. We therefore investigated the IRTA1 expression in non-neoplastic lymphoid tissues and 261 malignant lymphomas, examining the ability of a commercially available antibody to accurately diagnose MZL...
September 22, 2016: Human Pathology
Giorgos Bamias, Eirini Filidou, Dimitris Goukos, Vasilis Valatas, Konstantinos Arvanitidis, Maria Panagopoulou, Georgios Kouklakis, George L Daikos, Spiros D Ladas, George Kolios
Intestinal subepithelial myofibroblasts (SEMFs) exert a profibrotic role in Crohn's disease (CD). Tumor necrosis factor-like cytokine 1A (TL1A) and its receptors, death-domain receptor 3 (DR3) and decoy receptor 3 (DcR3), are mucosal factors with significant involvement in experimental inflammation and CD. We aimed to determine the regulation of expression of this system of proteins in SEMFs and intestinal epithelial cells. The relative amount of mRNA transcripts for TL1A, DR3, and DcR3 was measured by real-time reverse transcription polymerase chain reaction in cultured primary SEMFs, colonic myofibroblast cell line 18CO, and epithelial cell line HT29...
September 7, 2016: Translational Research: the Journal of Laboratory and Clinical Medicine
Cetin Karaca, Ebubekir S Daglilar, Ozlem Mutluay Soyer, Mine Gulluoglu, William R Brugge
BACKGROUND AND AIMS: Application of endoscopic submucosal resection (ESMR) in management of gastric subepithelial lesions (GSL) less than 20 mm is gradually increasing because it allows diagnosis and treatment at the same operative session. In this study we would like to compare and evaluate the benefits of ESMR with an endoscopic cap band mucosectomy technique or saline solution-assisted snare technique in GSLs smaller than 20 mm. METHODS: This was a retrospective analysis of a prospectively maintained database used at 2 academic tertiary care centers...
September 20, 2016: Gastrointestinal Endoscopy
Masaya Iwamuro, Takehiro Tanaka, Satoko Ando, Tatsuhiro Gotoda, Hiromitsu Kanzaki, Seiji Kawano, Yoshiro Kawahara, Hiroyuki Okada
A 68-year-old Japanese woman presented with a solitary pedunculated polyp in the duodenum. Endoscopic ultrasonography showed multiple cystic structures in the polyp. The polyp was successfully resected by endoscopic snare polypectomy and pathologically diagnosed as Brunner's gland hamartoma. Because hamartomatous components were not identified in the stalk of the polyp, we speculate that the stalk developed from traction of the normal duodenal mucosa. When a solitary, pedunculated polyp with cystic structure within the submucosa is found in the duodenum, Brunner's gland hamartoma should be considered in the differential diagnosis, despite the rarity of the disease...
2016: Case Reports in Gastrointestinal Medicine
Badr Al-Bawardy, Elizabeth Rajan, Louis M Wong Kee Song
BACKGROUND AND AIMS: Endoscopic full-thickness resection (EFTR) allows for definitive diagnosis and treatment of select subepithelial and epithelial lesions unsuitable to conventional resection techniques. Our aim was to evaluate the efficacy and safety of over-the-scope (OTS) clip-assisted EFTR for these lesions. METHODS: Patients who underwent OTS clip-assisted EFTR between June 2014 and October 2015 were analyzed. The procedure involved (1) thermal marking of the periphery of the lesion; (2) lesion suction into the cap of either an OTSC (Ovesco Endoscopy AG, Tübingen, Germany) or Padlock clip (Aponos Medical Corp, Kingston, NH, USA) with or without triprong anchor retraction of the lesion; (3) clip deployment; and (4) en bloc resection of the lesion above the clip using an electrosurgical snare and/or knife...
August 26, 2016: Gastrointestinal Endoscopy
Kazushiro Takei, Shinichi Shimizu, Yoshiro Otsuki
A 49-year-old man was demonstrated to have two tumors in the right kidney by computed tomographic scan during an examination for cholelithiasis. One was a fat rich solid tumor which was clinically diagnosed as angiomyolipoma, and the other was an unconfirmed cystic tumor. Cholecystectomy and radical nephrectomy were performed. Based on pathological findings, the solid tumor was diagnosed as common angiomyolipoma and the cystic tumor as angiomyolipoma with epithelial cysts (AMLEC). The cystic tumor consisted of 3 components : an epithelial cyst lined with single flat to cuboidal cells, a subepithelial compact stroma and an external layer of muscle predominant angiomyolipoma...
July 2016: Hinyokika Kiyo. Acta Urologica Japonica
Tae Wook Kim, Gwang Ha Kim, Do Youn Park, Sangjeong Ahn, Won Lim, Bon Eun Lee, Geun Am Song
BACKGROUND: Subepithelial tumors (SETs) in the gastrointestinal tract are often incidentally found during endoscopic examinations. Although the utility and safety of endoscopic resection (ER) of SETs in the esophagus and stomach have been described, data about the ER of duodenal SETs remain scant. Therefore, we aimed to investigate the clinical outcomes associated with the ER of duodenal SETs and to assess possible predictive factors for incomplete resection. METHODS: We conducted a retrospective observational study of 62 patients (64 lesions) that underwent ER of duodenal SETs between June 2005 and December 2015 at the Pusan National University Hospital...
August 23, 2016: Surgical Endoscopy
Froukje L J Cals, Senada Koljenović, José A Hardillo, Robert J Baatenburg de Jong, Tom C Bakker Schut, Gerwin J Puppels
BACKGROUND: Currently, up to 85% of the oral resection specimens have inadequate resection margins, of which the majority is located in the deeper soft tissue layers. The prognosis of patients with oral cavity squamous cell carcinoma (OCSCC) of the tongue is negatively affected by these inadequate surgical resections. Raman spectroscopy, an optical technique, can potentially be used for intra-operative evaluation of resection margins. OBJECTIVE: To develop in vitro Raman spectroscopy-based tissue classification models that discriminate OCSCC of the tongue from (subepithelial) non-tumorous tissue...
September 2016: Oral Oncology
Takeyuki Kono, Haruna Yabe, Kosuke Uno, Koichiro Saito, Kaoru Ogawa
OBJECTIVES/HYPOTHESIS: Recurrent respiratory papillomatosis (RRP) is a benign epithelial tumor that exhibits a high frequency of recurrence. This study assesses the vocal function after laser treatment for RRP, particularly in relation to the frequency of surgery. STUDY DESIGN: Retrospective study. METHODS: Thirty RRP patients who underwent laser surgery that controlled the tumor were included. Preoperative and postoperative Grade, Roughness, Breathiness, Asthenia, and Strain Scale, videostroboscopic findings, aerodynamic and acoustic parameters, and self-assessment questionnaires were measured and compared with an age- and sex-matched control group...
August 12, 2016: Laryngoscope
Osamu Goto, Hiroya Takeuchi, Motoki Sasaki, Hirofumi Kawakubo, Teppei Akimoto, Ai Fujimoto, Yasutoshi Ochiai, Tadateru Maehata, Toshihiro Nishizawa, Yuko Kitagawa, Naohisa Yahagi
Background and study aims: To avoid bacterial contamination and tumor seeding during gastrectomy surgery, we developed a nonexposure technique for endoscopic full-thickness resection with laparoscopic assistance. The feasibility and safety of nonexposed endoscopic wall-inversion surgery (NEWS) for gastric subepithelial tumors (SETs) were investigated. Patients and methods: For protruding gastric SETs ≤ 3 cm in diameter, NEWS was performed in the following sequence: laparoscopic seromuscular incision after endoscopic submucosal injection, laparoscopic seromuscular suturing with the lesion inverted, endoscopic mucosal and submucosal incision, and transoral retrieval...
July 22, 2016: Endoscopy
Won Jik Lee, Sung Min Park, Byung Wook Kim, Joon Sung Kim, Jeong Seon Ji, Hwang Choi
Neurofibromas are benign, slow-growing nerve sheath tumors of the peripheral nervous system, arising from Schwann cells, and classically associated with neurofibromatosis type 1 (Nf1, von Recklinghausen's disease). They occur rarely in the gastro-intestinal tract as isolated neoplasms, outside the classical clinical feature of neurofibromatosis. We herein present an isolated colonic neurofibroma without any systemic signs of neurofibromatosis. A 59-year-old female came to our hospital for constipation. On physical examination, general appearance showed no definite skin lesions...
July 25, 2016: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
Jae Pil Han, Tae Hee Lee, Su Jin Hong, Hee Kyung Kim, Hyung Min Noh, Yun Nah Lee, Hyun Jong Choi
OBJECTIVE: Adequate tissue acquisition for immunohistochemical (IHC) analysis is important in the differential diagnosis of subepithelial tumors (SETs). We compared the diagnostic yield from IHC analysis between endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and EUS-guided fine needle biopsy (EUS-FNB) after on-site cytologic evaluation for cellularity in gastric SETs. METHODS: In 22 patients with gastric SET, EUS-guided tissue sampling was performed on the same of SETs in a randomized sequence with EUS-FNA followed by EUS-FNB, or vice versa...
July 16, 2016: Journal of Digestive Diseases
Joon Sung Kim, Byung-Wook Kim, Gi Jun Kim, Young Wook Kim, Seung Ji Ryu, Sung Min Park, Jeong-Seon Ji, Sun Young Jun
BACKGROUND: Several techniques are recommended for the histologic diagnosis of gastric subepithelial tumors (SETs). The purpose of our study was to evaluate the diagnostic yield and safety of endoscopic ultrasonography-guided single-incision needle knife (SINK) biopsy for the diagnosis of gastric SETs. METHODS: A retrospective review of patients who received biopsy for gastric SETs from August 2012 to May 2015 was conducted. Patients who received endoscopic ultrasonography and were found to have a SET originating from the muscularis propria of the stomach were included in the study...
June 28, 2016: Surgical Endoscopy
Hyuk Soon Choi, Hoon Jai Chun, Kyoung-Oh Kim, Eun Sun Kim, Bora Keum, Yoon-Tae Jeen, Hong Sik Lee, Chang Duck Kim
Here, we report the first successful endoscopic resection of an exophytic gastrointestinal stromal tumor (GIST) using a novel perforation-free suction excavation technique. A 49-year-old woman presented for further management of a gastric subepithelial tumor on the lesser curvature of the lower body, originally detected via routine upper gastrointestinal endoscopy. Abdominal computed tomography and endoscopic ultrasound showed a 4-cm extraluminally protruding mass originating from the muscularis propria layer...
June 21, 2016: World Journal of Gastroenterology: WJG
Su Young Kim, Kyoung Oh Kim
With the wide use of esophagogastroduodenoscopy, the incidence of gastric subepithelial tumor (SET) diagnosis has increased. While the management of large or symptomatic gastric SETs is obvious, treatment of small (≤ 3 cm) asymptomatic gastric SETs remains inconclusive. Moreover, the presence of gastrointestinal stromal tumors with malignant potential is of concern, and endoscopic treatment of gastric SETs remains a subject of debate. Recently, numerous studies have demonstrated the feasibility of endoscopic treatment of gastric SETs, and have proposed various endoscopic procedures including endoscopic submucosal dissection, endoscopic muscularis dissection, endoscopic enucleation, endoscopic submucosal tunnel dissection, endoscopic full-thickness resection, and a hybrid approach (the combination of endoscopy and laparoscopy)...
June 10, 2016: World Journal of Gastrointestinal Endoscopy
Mehmet Tahir Oruç, Tuğrul Çakir, Arif Aslaner, Sema Çekiç, Alkan Sakar, Erdem Can Yardimci
Gastric glomus tumors (GGTs) are unusual benign, subepithelial, mesenchymal neoplasms of modified smooth muscle cells representing a neoplastic counterpart of glomus bodies. A 38-year-old woman was admitted to our clinic presenting morbid obesity. Routine preoperative evaluations, such as laboratory analysis, abdominal ultrasonography, and upper gastrointestinal endoscopy, were performed. She underwent a classical laparoscopic sleeve gastrectomy (LSG). The postoperative course was uneventful and she was discharged for outpatient control...
January 2016: Autopsy & case reports
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