Intest Res.  2019 Jul;17(3):398-403. 10.5217/ir.2018.00161.

Endoscopic features of gastrointestinal stromal tumor in the small intestine

• Ihara Y
• Torisu T
• Moriyama T
• Umeno J
• Hirano A
• Okamoto Y
• Hori Y
• Yamamoto H
• Kitazono T
• Esaki M

• KMID: 2454748
• DOI: http://doi.org/10.5217/ir.2018.00161

Abstract

BACKGROUND/AIMS
Gastrointestinal stromal tumor (GIST) is one of the most common types of submucosal tumors (SMTs). Because of GIST's malignant potential, it is crucial to differentiate it from other SMTs. The present study aimed to identify characteristic endoscopic findings of GISTs in the small intestine.
METHODS
We reviewed the clinicopathological and endoscopic findings of 38 patients with endoscopically or surgically resected SMTs in the small intestine. SMTs were classified into GIST and non-GIST groups, and clinicopathological and endoscopic findings were compared between the 2 groups.
RESULTS
Fifteen patients had GIST and 23 patients had other types of SMTs in the small intestine. Comparison of the endoscopic findings between the 2 groups revealed that dilated vessels in the surrounding mucosa were significantly more in number in the GIST group than in the non-GIST group (P<0.05). However, there were no other differences in endoscopic findings between the 2 groups. Among patients with GISTs, the presence of dilated vessels in the surrounding mucosa was not associated with bleeding risk, tumor size, or metastasis rate at diagnosis.
CONCLUSIONS
Dilated vessels in the surrounding mucosa, identified during balloon-assisted endoscopy, may be a diagnostic indicator for GIST in the small intestine. However, its clinical significance should be further analyzed.

Keyword

Balloon-assisted enteroscopy; Dilated vessel; Gastrointestinal stromal tumors; Intestine, small

MeSH Terms

Diagnosis
Endoscopy
Gastrointestinal Stromal Tumors*
Hemorrhage
Humans
Intestine, Small*
Mucous Membrane
Neoplasm Metastasis

Figure

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  Fig. 1. Double-balloon endoscopy images of gastrointestinal stromal tumor. (A) Multinodular submucosal tumor with tortuous dilated vessels. (B) Blue dilated vessels on the surface of the tumor and surrounding mucosa.

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  Fig. 2. Representative images of submucosal tumor other than gastrointestinal stromal tumor. (A) Follicular lymphoma. (B) Mucosa-associated lymphoid tissue lymphoma. (C) Diffuse large B-cell lymphoma. (D) T-cell lymphoma. (E) Heterotopic pancreas. (F) Dedifferentiated liposarcoma.

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