Diagnosis of subepithelial tumors in the upper gastrointestinal tract by endoscopic ultrasonography

Figure 1 Normal structure of the gastric wall with five endoscopic ultrasonography layers present.

Figure 2 Endoscopic and endoscopic ultrasonography finding of extrinsic compression. A: Endoscopic view of subepithelial lesion of the gastric angle; B: Endoscopic ultrasonography shows an extramural compression by a liver cyst.

Figure 3 Endoscopic and endoscopic ultrasonography finding of lipomas. A: Endoscopic view of 1.5 cm subepithelial lesion of the anterior part of the gastric angle; B: Endoscopic ultrasonography shows an typical aspect of an 1.6 cm lipoma of the gastric angle (arrows).

Figure 4 Endoscopic and endoscopic ultrasonography finding of ectopic pancreas. A: Endoscopic view of a subepithelial lesion of the greater curvature of the gastric antrum, covered with normal mucosa, with a central depression; B: Endoscopic ultrasonography shows indistinct margin, hypoechoic tumor developed within the 4th layer.

Figure 5 Hypoechoic tumor developed within the 4th layer. A: Leiomyoma of the esophagus (30 mm); B: Schwannoma of the stomach (22 mm).

Figure 6 Endoscopic and endoscopic ultrasonography finding of gastrointestinal stromal tumor. A: Endoscopic view of subepithelial lesion of the posterior side of the greater curvature of the gastric body; B: Endoscopic ultrasonography shows hypoechoic, homogeneous 2 cm tumor developed within the 4th layer (low risk gastrointestinal stromal tumor of the stomach); C: 35 mm hypoechoic, heterogeneous, lobulated submucosal lesion with exogastric growth developed within the 4th layer (high risk gastrointestinal stromal tumor of the stomach).

Figure 7 Endoscopic ultrasonography-guided fine needle aspiration of a 20 mm hypoechoic subepithelial tumor of the stomach, using a 25-gauge (arrows).