Clinical Significance of Endoscopic Ultrasonography in Gastritis Cystica Polyposa

Abstract

Background/Aims: Gastritis cystica polyposa (GCP) is one of multiple cystic lesions in the stomach. Endoscopic ultrasonography (EUS) is the best diagnostic tool to evaluate small gastric cystic lesions at a preoperative state. The aim of this study is to evaluate the endoscopic and typical EUS findings of GCP. Methods: From January 1995 to November 1999, nine cases of GCP were confirmed by endoscopic resection or operation. We analyzed clinical features, endoscopic findings, and EUS findings and compared them with histologic diagnosis. Results: Endoscopic findings of GCP were varied: 3 gastric polyps, 2 submucosal tumors (SMT), 2 flat elevated lesions, 1 hypertrophic gastritis, and 1 small polyp coexisting with gastric cancer. EUS findings were characterized by a mean size of 14.1 mm (9∼26 mm), multiple variable-sized anechoic lesions with intervening hyperechoic structures (8 cases), irregular margins (7), mucosa and submucosal thickening (6), and submucosal invasion by anechoic lesions (5 GCP profunda). In histologic findings, 6 GCP were associated with underlying gastritis only, 2 GCP with gastric tubular adenomas, and 1 GCP with EGC. Conclusions: Endoscopic findings vary enough that endoscopists cannot initially confirm any impressions of GCP. EUS is an effective diagnostic tool to evaluate and differentiate GCP from protruding and elevated gastric lesions, and plays an important role to decide treatment methods for GCP and/or it's associated gastric tumorous lesions.