위장관 ; 위장관기질종양과 구별되는 위 신경초종의 초음파 내시경 특징

• Published in: The Korean journal of gastroenterology Vol. 65; no. 1; pp. 21 - 26
• Main Authors: 박형철, Hyung Chul Park, 손동준, Dong Jun Son, 오형훈, Hyung Hoon Oh, 옥찬영, Chan Young Oak, 김미영, Mi Young Kim, 정조윤, Cho Yun Chung, 명대성, Dae Seong Myung, 김종선, Jong Sun Kim, 조성범, Sung Bum Cho, 이완식, Wan Sik Lee, 주영은, Young Eun
• Format: Journal Article
• Language: Korean
• Published: 대한소화기학회 31.01.2015
• Subjects: Endoscopy; Gastrointestinal stromal tumors; Schwannoma; Stomach; Ultrasonography
• ISSN: 1598-9992

Background/Aims: Gastric schwannoma (GS), a rare neurogenic mesenchymal tumor, is usually benign, slow-growing, and asymptomatic. However, GS is often misdiagnosed as gastrointestinal stromal tumors (GIST) on endoscopic and radiological examinations. The purpose of this study was to evaluate EUS characteristics of GS distinguished from GIST. Methods: A total of 119 gastric subepithelial lesions, including 31 GSs and 88 GISTs, who were histologically identified and underwent EUS, were enrolled in this study. We evaluated the EUS characteristics, including location, size, gross morphology, mucosal lesion, layer of origin, border, echogenic pattern, marginal halo, and presence of an internal echoic lesion by retrospective review of the medical records. Results: GS patients comprised nine males and 22 females, indicating female predominance. In the gross morphology according to Yamada`s classification, type I was predominant in GS and type III was predominant in GIST. In location, GSs were predominantly located in the gastric body and GISTs were predominantly located in the cardia or fundus. The frequency of 4th layer origin and isoechogenicity as compared to the echogenicity of proper muscle layer was significantly more common in GS than GIST. Although not statistically significant, marginal halo was more frequent in GS than GIST. The presence of an internal echoic lesion was significantly more common in GIST than GS. Conclusions: The EUS characteristics, including tumor location, gross morphology, layer of origin, echogenicity in comparison with the normal muscle layer, and presence of an internal echoic lesion may be useful in distinguishing between GS and GIST.