Learning objectives
The purpose of this exhibit is:
To understand stomach anatomy and layer structure via computed tomography (CT) and endoscopic ultrasound.
To understand the imaging findings of gastric submucosal tumor via CT and endoscopic ultrasound and the advantages of these imaging techniques based on pathological correlations.
Background
A gastric submucosal tumor is defined as a gastric tumor covered with normal mucous membrane.
It is often accidentally discovered during endoscopy,
radiography,
or surgery.
Gastric submucosal tumors are observed in many diseases,
including lipomas,
leiomyomas,
and schwannomas,
in addition to GIST.
Although a gastric submucosal tumor is often derived from the mesenchymal system,
diagnosis can become difficult when the imaging findings overlap with those of other tumors.
For a definitive diagnosis,
multiple imaging inspections,
such as GF,
US,
EUS,
CT,
and MRI,
should be...
Findings and procedure details
Anatomy
The stomach is divided into the cardia,
fundus,
body,
antrum,
and pylorus.
The stomach wall is made up of several layers of tissue:
Mucosa : the mucous membrane layer of the stomach which contains the many glands and the gastric pits.
Submucosa : A layer of connective tissue that has large blood vessels,
lymph glands,
nerve cells and fibres,
and glands that secrete digestive hormones.
Muscularis propria (or muscularis externa) : The main muscle of the stomach,
and is made up of 3 layers...
Conclusion
Although gastric submucosal tumors are sometimes difficult to diagnose,
combining multiple examinations,
such as endoscopic ultrasound,
CT,
and upper gastrointestinal endoscopy,
can enable to narrow down the list of differential diagnoses,
thus leading to definitive diagnosis.
References
Insko EK,
Levine MS,
Birnbaum BA,
Jacobs JE.
Benign and Malignant Lesions of the Stomach: Evaluation of CT Criteria for Differentiation.
Radiology.
2003 Jul;228(1):166-71.
Oh JY,
Nam KJ,
Choi JC,
Cho JH,
Yoon SK,
Choi SS,
Kwon HJ,
Yoon JH,
Kim SJ.
Benign submucosal lesions of the stomach and duodenum: imaging characteristics with endoscopic and pathologic correlation.
Eur J Radiol.
2008 Jul;67(1):112-24.
Kang HC,
Menias CO,
Gaballah AH,
Shroff S,
Taggart MW,
Garg N,
Elsayes KM.
Beyond the GIST: mesenchymal tumors of the stomach.
Radiographics....