scholarly journals Status of the Gastric Mucosa with Endoscopically Diagnosed Gastrointestinal Stromal Tumor

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Kouichi Nonaka ◽  
Shinichi Ban ◽  
Yoshimitsu Hiejima ◽  
Rei Narita ◽  
Michio Shimizu ◽  
...  
Keyword(s):  
Gastric Mucosa ◽  
Gastrointestinal Stromal Tumor ◽  
Submucosal Tumor ◽  
Stromal Tumor ◽  
Upper Gastrointestinal Endoscopy ◽  
Submucosal Tumors ◽  
Gastric Gists ◽  
Mri Features ◽  
H Pylori ◽  
Ct And Mri

Background. Since gastrointestinal stromal tumor (GIST) is a mesenchymal submucosal tumor, the endosonographic, CT, and MRI features of gastric GISTs have been widely investigated. However, the GIST-bearing gastric mucosa status has not been reported. Objective. To characterize the GIST-bearing gastric mucosa status in terms of the degree of inflammation and atrophy, assessed endoscopically. Subjects and Methods. The subjects were 46 patients with submucosal tumors (histologically proven gastric GISTs) who had undergone upper gastrointestinal endoscopy in our hospital between April 2007 and September 2012. They were retrospectively evaluated regarding clinicopathological features, the endoscopically determined status of the entire gastric mucosa (presence or absence and degree of atrophy), presence or absence and severity of endoscopic gastritis/atrophy (A-B classification) at the GIST site, and presence or absence of H. pylori infection. Results. Twenty-three patients had no mucosal atrophy, but 17 and 6 had closed- and open-type atrophy, respectively. Twenty-six, 5, 12, 1, 1, and 1 patients had grades B0, B1, B2, B3, A0, and A1 gastritis/atrophy at the lesion site, respectively, with no grade A2 gastritis/atrophy. Conclusion. The results suggest that gastric GISTs tend to arise in the stomach wall with H. pylori-negative, nonatrophic mucosa or H. pylori-positive, mildly atrophic mucosa.

scholarly journals A Case of Gastrointestinal Stromal Tumor That Underwent Endoscopic Ultrasound-Guided Aspiration with a 25-Gauge Biopsy Needle

2016 ◽  
Vol 10 (1) ◽  
pp. 173-178
Author(s):  
Minoru Tomizawa ◽  
Fuminobu Shinozaki ◽  
Yasufumi Motoyoshi ◽  
Takao Sugiyama ◽  
Shigenori Yamamoto ◽  
...  
Keyword(s):  
Gastrointestinal Stromal Tumor ◽  
Endoscopic Ultrasound ◽  
Submucosal Tumor ◽  
Gastric Wall ◽  
Stromal Tumor ◽  
Upper Gastrointestinal Endoscopy ◽  
Ultrasound Guided ◽  
Biopsy Needle ◽  
Doppler Image ◽  
Hypoechoic Lesion

Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is performed to obtain specimens for pathological analysis. For this procedure, 19-gauge (19G), 22-guage (22G), and 25-guage (25G) needles are available. The needles are classified into aspiration type and biopsy type. A 56-year-old woman underwent upper gastrointestinal endoscopy that showed a 38-mm-diameter submucosal tumor. The elevated lesion was diagnosed as a submucosal tumor of the stomach. Contrast-enhanced computed tomography showed a low-density area on the luminal surface of the gastric wall, which was covered with a thin layer of gastric mucosa. EUS showed a hypoechoic lesion in the submucosal layer. Color Doppler image showed a pulsating vascular signal extending into the center of the hypoechoic lesion from the periphery. EUS-FNA was performed with a 25G biopsy needle. The specimen tissue consisted of spindle-shaped cells. The cells were positive for CD117 and CD34. The submucosal tumor was diagnosed as a gastrointestinal stromal tumor.

scholarly journals Preoperatively diagnosed gastric collision tumor with mixed adenocarcinoma and gastrointestinal stromal tumor: a case report and literature review

2021 ◽  
Author(s):  
Kunihiko Matsuno ◽  
Yoshikazu Kanazawa ◽  
Daisuke Kakinuma ◽  
Nobutoshi Hagiwara ◽  
Fumihiko Ando ◽  
...  
Keyword(s):  
Gastrointestinal Stromal Tumor ◽  
Distal Gastrectomy ◽  
Submucosal Tumor ◽  
Smooth Muscle Actin ◽  
Collision Tumor ◽  
Stromal Tumor ◽  
Lower Body ◽  
Muscle Actin ◽  
First Case ◽  
S 100

AbstractReports of gastric collision tumors, comprising adenocarcinoma and gastrointestinal stromal tumor, are extremely rare. Here, we report the case of a 68-year-old male who was diagnosed with a lower-body, moderately differentiated, tubular-type adenocarcinoma and submucosal tumor and underwent an elective D2 distal gastrectomy. The tumor cells of the gastrointestinal stromal tumor were positive for H-caldesmon and CD117, weakly positive for smooth muscle actin and DOG-1, and negative for desmin, S-100 protein, CD31, and AE1/AE3. The tumor had grown into a mixed form of adenocarcinoma and gastrointestinal stromal tumor. Thus, we report the first case of a preoperatively diagnosed collision tumor in the stomach consisting of adenocarcinoma and gastrointestinal stromal tumor.

Gastrointestinal stromal tumor arising in the rectovaginal septum

2004 ◽  
Vol 14 (2) ◽  
pp. 373-377 ◽  
Author(s):  
K. Nasu ◽  
T. Ueda ◽  
S. Kai ◽  
H. Anai ◽  
Y. Kimura ◽  
...  
Keyword(s):  
Gastrointestinal Stromal Tumor ◽  
Submucosal Tumor ◽  
Rectal Wall ◽  
Rectal Mucosa ◽  
Pelvic Lymphadenectomy ◽  
Japanese Woman ◽  
Stromal Tumor ◽  
Resected Specimen ◽  
Rectovaginal Septum ◽  
Tissue Mass

We report herein a rare case of malignant gastrointestinal stromal tumor (GIST) originated from the rectal wall, which presented as a tumor on the rectovaginal septum.A 54-year-old Japanese woman, gravida 4, para 3, was admitted complaining of anuresis and severe constipation. She had a history of hysterectomy and right salpingo-oophorectomy for uterine leiomyoma 11 years previously. Pelvic examination revealed an 8.5 × 7.5 × 7.5 cm hard mass in the rectovaginal space. The inferior border of the tumor was 2 cm from the vaginal introitus and 2 cm from the anus. Computed tomography and magnetic resonance imaging showed a well-circumscribed soft-tissue mass filling the rectovaginal space. Urinary bladder and rectum were markedly compressed and displaced. Colon fiberscopy revealed invasion of the tumor into the rectal mucosa. An abdominoperineal resection of the rectum with posterior vaginal wall resection and pelvic lymphadenectomy was performed. The resected specimen showed a rectal submucosal tumor that was 8 × 8 × 7 cm in size. The tumor was diagnosed as a malignant GIST. Immunohistochemical analysis confirmed this diagnosis. The patient is now healthy without evidence of recurrence at 13 months after surgery.Gynecologists should be aware of rectal GIST arising in the rectovaginal space as a differential diagnosis of vaginal submucosal tumor.

scholarly journals Prevalence of dual clarithromycin and metronidazole resistance in Helicobacter pylori estimated by molecular methods in Santiago, Chile

2017 ◽  
Author(s):  
Patricio Gonzalez-Hormazabal ◽  
Maher Musleh ◽  
Susana Escandar ◽  
Hector Valladares ◽  
Enrique Lanzarini ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Gastric Mucosa ◽  
Initial Approximation ◽  
Molecular Methods ◽  
University Hospital ◽  
Upper Gastrointestinal Endoscopy ◽  
Metronidazole Resistance ◽  
Two Samples ◽  
H Pylori ◽  
Upper Gastrointestinal

AbstractBackgroundCurrent available treatments for Helicobacter pylori eradication are chosen according to local clarithromycin and metronidazole resistance prevalence. The aim of this study was to estimate, by means of molecular methods, both clarithromycin and metronidazole resistance in gastric mucosa from patients infected with H.pylori.MethodsA total of 191 DNA samples were analyzed. DNA was purified from gastric mucosa obtained from patients who underwent an upper gastrointestinal endoscopy at an university hospital from Santiago, Chile, between 2011 and 2014. H.pylori was detected by real-time PCR. A 5’exonuclease assay was developed to detect A2142G and A2143G mutations among Hpylori-positive samples. rdxA gene was sequenced in samples harboring A2142G and A2143G mutations in order to detect mutations that potentially confer dual clarithromycin and metronidazole resistance.ResultsNinety-three (93) out of 191 DNA samples obtained from gastric mucosa were H. pylori-positive (48.7%). Clarithromycin-resistance was detected in 29 samples (31.2% [95%CI 22.0%-41.6%]). The sequencing of rdxA gene revealed that two samples harbored truncating mutations in rdxA, one sample had an in-frame deletion, and 11 had amino acid changes that likely cause metronidazole resistance.ConclusionsWe estimated a prevalence of clarithomycin-resistance of 31.8% in Santiago, Chile. The proportion of dual clarithromycin and metronidazole resistance could be, at least, 15.0%. Our results require further confirmation. Nevertheless, they are significant as an initial approximation in re-evaluating the guidelines for H.pylori eradication currently used in Chile.

scholarly journals Heterotopic Gastric Mucosa in Gastric Propria Muscularis Treated by Endoscopic Submucosal Dissection: A Case Report and Literature Review.

2021 ◽  
Author(s):  
Yuting Jia ◽  
Erfeng Li ◽  
Zhen Zhang ◽  
Bin Guo ◽  
Xing Chen
Keyword(s):  
Gastric Mucosa ◽  
Endoscopic Submucosal Dissection ◽  
Submucosal Tumor ◽  
Anatomical Variation ◽  
Abdominal Distension ◽  
Normal Mucosa ◽  
Heterotopic Gastric Mucosa ◽  
Upper Gastrointestinal Endoscopy ◽  
Submucosal Dissection ◽  
Mucosal Glands

Abstract Background: Heterotopic gastric mucosa（HGM）is a congenital anatomical variation. It can occur in various tissues and organs of the gastrointestinal tract. Part of the HGM appeared as a solitary, sessile submucosal lesions covered with normal mucosa, and because it was relatively rare, thereby resulting in some HGM to be easily missed or misdiagnosed. We report on a case of heterotopic gastric mucosa in gastric propria muscularis.Case presentation: A 32-year-old man with abdominal distension for one month. Upper gastrointestinal endoscopy revealed hemispherical lesion covered with smooth mucosa located in gastric antrum. Endoscopic ultrasound (EUS) revealed that it might be derived from the submucosa, with no echogenic nodules, and a partition is visible inside. Endoscopic submucosal dissection (ESD) was performed and histological examination revealed scattered heterotopic mucosal glands (HGG) located in the propria muscularis. Regular follow-up, the patient's abdominal distension was significantly relieved.Conclusion: HGM of the type of submucosal tumor-like lesion is rare. EUS is a well-established method for submucosal lesion. On EUS, these lesions showed cystic anechoic central core in the submucosa with no solid component,which is similar to gastric cyst. Therefore, this requires us to be alert to the possibility of HGM in order to further evaluate and treat, and if necessary, it can be removed by ESD.

scholarly journals Distinction of surgically resected gastrointestinal stromal tumor by near-infrared hyperspectral imaging

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Daiki Sato ◽  
Toshihiro Takamatsu ◽  
Masakazu Umezawa ◽  
Yuichi Kitagawa ◽  
Kosuke Maeda ◽  
...  
Keyword(s):  
Machine Learning ◽  
Gastrointestinal Stromal Tumor ◽  
Hyperspectral Imaging ◽  
Near Infrared ◽  
Submucosal Tumor ◽  
Stromal Tumor ◽  
Training Data ◽  
Support Vector ◽  
Gastric Gist ◽  
Mucosal Layer

AbstractThe diagnosis of gastrointestinal stromal tumor (GIST) using conventional endoscopy is difficult because submucosal tumor (SMT) lesions like GIST are covered by a mucosal layer. Near-infrared hyperspectral imaging (NIR-HSI) can obtain optical information from deep inside tissues. However, far less progress has been made in the development of techniques for distinguishing deep lesions like GIST. This study aimed to investigate whether NIR-HSI is suitable for distinguishing deep SMT lesions. In this study, 12 gastric GIST lesions were surgically resected and imaged with an NIR hyperspectral camera from the aspect of the mucosal surface. Thus, the images were obtained ex-vivo. The site of the GIST was defined by a pathologist using the NIR image to prepare training data for normal and GIST regions. A machine learning algorithm, support vector machine, was then used to predict normal and GIST regions. Results were displayed using color-coded regions. Although 7 specimens had a mucosal layer (thickness 0.4–2.5 mm) covering the GIST lesion, NIR-HSI analysis by machine learning showed normal and GIST regions as color-coded areas. The specificity, sensitivity, and accuracy of the results were 73.0%, 91.3%, and 86.1%, respectively. The study suggests that NIR-HSI analysis may potentially help distinguish deep lesions.

Anorectal gastrointestinal stromal tumor mimicking prostatic tumor on CT and MRI

2005 ◽  
Vol 53 (3) ◽  
pp. 115-118 ◽  
Author(s):  
Tadao Hiromura ◽  
Takeshi Nishioka ◽  
Seiko Nishioka ◽  
Hiroyuki Ikeda ◽  
Kazuo Tomita
Keyword(s):  
Gastrointestinal Stromal Tumor ◽  
Stromal Tumor ◽  
Prostatic Tumor ◽  
Ct And Mri

Single-Incision Laparoscopic Surgery for Partial Gastrectomy in Patients with a Gastric Submucosal Tumor

2012 ◽  
Vol 78 (4) ◽  
pp. 447-450 ◽  
Author(s):  
Tsunehiro Takahashi ◽  
Hiroya Takeuchi ◽  
Hirofumi Kawakubo ◽  
Yoshiro Saikawa ◽  
Norihito Wada ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Gastrointestinal Stromal Tumor ◽  
Single Incision ◽  
Submucosal Tumor ◽  
Partial Gastrectomy ◽  
Stromal Tumor ◽  
Pathological Examination ◽  
Single Incision Laparoscopic Surgery ◽  
Gastric Submucosal Tumor ◽  
Vessel Sealing

Since 2010, we have used single-incision laparoscopic surgery (SILS) for patients with a gastric submucosal tumor, as a less invasive alternative to conventional laparoscopy. From September 2010 to January 2011, five patients underwent a local resection for a gastric submucosal tumor using a SILS™ port at Keio University Hospital. We performed partial gastrectomy via the SILS™ port using a 5 mm flexible endoscope, a vessel sealing system, and a stapling device. There were no major intraoperative complications, conversion to laparotomy, or cases of tumor rapture. The average operative time was 89 (range, 72–129) minutes with minimal blood loss. Pathological examination revealed four cases of gastrointestinal stromal tumor and one case of inflammatory fibrosis caused by nonspecific inflammation. Although we examined only a small number of cases in this study, the results suggested that SILS gastrectomy can be performed safely and effectively for gastrointestinal stromal tumor.

scholarly journals Endoscopic resection of giant gastrointestinal stromal tumor at the esophagogastric junction: a case report

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Feng Xue ◽  
Wei Wang ◽  
Ning Shi ◽  
Xing-Bin Ma ◽  
Cheng-Xia Liu
Keyword(s):  
Endoscopic Resection ◽  
Esophagogastric Junction ◽  
Submucosal Tumor ◽  
Stromal Tumor ◽  
Upper Gastrointestinal Endoscopy ◽  
Case Presentation ◽  
Invasive Method ◽  
Endoscopic Submucosal Excavation ◽  
Upper Gastrointestinal ◽  
Abdominal Fullness

Abstract Background Gastrointestinal stromal tumors (GISTs) at the esophagogastric junction are rare and its treatment is complicated and challenging. Endoscopic resection has advantages with less complications compared to open and laparoscopic surgery. Case presentation We report a 33-year-old male patient who was admitted to our department complaining of abdominal fullness for 20 days. A huge submucosal tumor at the esophagogastric junction was found by upper gastrointestinal endoscopy. We successfully resected the lesion through endoscopic submucosal excavation without complications, which was pathologically confirmed to be a GIST. The patient was discharged 5 days after operation and has been doing well, and there was no recurrence 8 months after the operation. Conclusion ESE is possibly an effective and minimally invasive method of giant esophagogastric junction stromal tumor.

scholarly journals A Gastrointestinal Stromal Tumor of the Stomach Demonstrating a Stepwise Progression from Low- to High-Grade Malignancy

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Takahiko Nakajima ◽  
Tomonori Ushijima ◽  
Atsushi Kihara ◽  
Kenichiro Murata ◽  
Toshiro Sugiyama ◽  
...  
Keyword(s):  
Gastrointestinal Stromal Tumor ◽  
Clinical Course ◽  
Submucosal Tumor ◽  
Histological Finding ◽  
Stromal Tumor ◽  
Gastric Gist ◽  
High Grade ◽  
Grade Malignancy ◽  
Multiple Liver Metastases ◽  
High Grade Malignancy

We report a case of a gastrointestinal stromal tumor (GIST) of the stomach that demonstrated a stepwise progression from low- to high-grade malignancy. The patient had been followed for a small gastric submucosal tumor that had turned malignant after 8 years of indolence, manifested by tarry stools. The tumor was enucleated, and gastric GIST was diagnosed. The most significant histological finding was that the tumor comprised two clearly demarcated areas, one with less aggressive characteristics and the other with highly aggressive characteristics. The patient exhibited multiple liver metastases 24 months after surgery. Imatinib mesylate was not administered throughout the clinical course because it was not available for clinical use at that time. The patient followed an unfavorable clinical course and died of liver dysfunction 55 months after surgery. Autopsy was performed. By comparing the immunohistochemical profiles of primary and metastatic tumors, it was established that only the tumor cells with highly aggressive characteristics had metastasized.

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