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      Idiopathic granulomatous gastritis diagnosed with endoscopic ultrasound-guided fine-needle aspiration: report of a case

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          Abstract

          A 71-year-old man in whom a gastric submucosal lesion was found incidentally was referred to our hospital for detailed examination. Esophagastroduodenoscopy showed a submucosal lesion in the body of the stomach. Endoscopic ultrasound revealed a 15-mm hypoechoic round mass with calcifications arising from the muscular layer. Confusing the diagnosis, it resembled a gastrointestinal mesenchymal tumor. Subsequently, endoscopic ultrasound-guided fine-needle aspiration was conducted for definitive diagnosis. Pathologic analysis showed a granuloma. Because this patient had no prior exposure to tuberculosis or Helicobacter pylori infection and had no abnormal laboratory data, this submucosal lesion was diagnosed as idiopathic granulomatous gastritis.

          Most cited references8

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          A guide for the diagnosis and management of gastrointestinal stromal cell tumors.

          Gastrointestinal stromal cell tumors (GISTs) are the most common mesenchymal neoplasm of the gastrointestinal tract and are frequently detected on routine endoscopy. Although only approximately 10-30% of GISTs are clinically malignant, all may have some degree of malignant potential. Preoperative determination of malignancy risk can be estimated from tumor size and location, but reliable histopathologic criteria are not currently available. Given such biological uncertainty, accurate diagnosis is essential to differentiate these lesions from other truly benign, subepithelial tumors. Endoscopic ultrasound-guided fine-needle aspiration has emerged as an important procedure to secure a tissue diagnosis of a GIST. When encountering GISTs, gastroenterologists are faced with challenging management decisions, especially in the face of small, incidentally discovered lesions. The majority of localized GISTs are managed via surgical resection, although a select few may be observed using serial endoscopic ultrasound examinations. This Review provides a general overview of GISTs, with an emphasis on their endoscopic diagnosis, the management of localized disease, and the management of incidentally discovered GISTs.
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            The role of endosonography in submucosal tumours.

            Submucosal tumours (SMTs) are relatively common findings in patients undergoing endoscopy, especially in upper gastrointestinal (GI) tract. This term includes various non-neoplastic and neoplastic conditions. Endoscopic ultrasonography (EUS) is the best imaging procedure to characterise SMT and to determine the need for further explorations. In this review, the following issues will be addressed: the endosonographic features of SMT; the diagnostic accuracy of EUS; the ability of EUS to distinguish benign and malignant SMTs; the value of EUS-guided fine-needle aspiration (FNA); and the influence of EUS on clinical management.
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              Multicenter randomized controlled trial comparing the performance of 22 gauge versus 25 gauge EUS-FNA needles in solid masses.

              Few randomized studies have assessed the clinical performance of 25-gauge (25G) needles compared with 22-gauge (22G) needles during endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) biopsy of intra-abdominal lesions. We aimed to compare the diagnostic yield, as well as performance characteristics of 22G versus 25G EUS biopsy needles by determining their diagnostic capabilities, the number of needle passes as well as cellularity of aspirated tissue specimen.
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                Author and article information

                Journal
                Endosc Int Open
                Endosc Int Open
                10.1055/s-0034-1377934
                Endoscopy International Open
                © Georg Thieme Verlag KG (Stuttgart · New York )
                2364-3722
                2196-9736
                December 2014
                24 October 2014
                : 2
                : 4
                : E259-E261
                Affiliations
                Department of Gastroenterology, Fukushima Medical University, Aizu Medical Center, Aizuwakamatsu, Japan
                Author notes
                Corresponding author Atsushi Irisawa, MD, PhD Department of Gastroenterology Fukushima Medical University Aizu Medical Center 21-2, Maeda, Tanisawa, KawahigashiAizuwakamatsu 969-3492Japan+81-242-75-2568 irisawa@ 123456fmu.ac.jp
                Article
                10.1055/s-0034-1390744
                4423308
                c1510550-8204-411d-b5b0-969c4600e05c
                © Thieme Medical Publishers
                History
                : 26 May 2014
                : 08 September 2014
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