Document Detail

Where has the tumor gone? The characteristics of cases of negative pathologic diagnosis after endoscopic mucosal resection.
MedLine Citation:
PMID:  19693749     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND STUDY AIMS: Discrepancies can occur between the histopathological findings from forceps biopsy and endoscopic mucosal resection (EMR), and occasionally in embarrassing cases tumorous tissue is not found at EMR. The aim of the present study was to evaluate the clinical, endoscopic, and histological features of gastric tumors in patients with pathololgically negative findings at EMR. PATIENTS AND METHODS: We retrospectively reviewed data from all patients with gastric tumor treated with EMR or endoscopic submucosal dissection (ESD) between August 1999 and April 2007 at our institution, and enrolled into the study patients with no tumor tissue found at mucosal resection. Their biopsy and EMR specimen slides were reviewed by a single pathologist. Patient characteristics, including demographic and clinical features, and the endoscopic appearance of mucosal lesions were evaluated. RESULTS: Out of 633 patients treated with EMR or ESD, 20 patients (3.2 %) were included. The mean +/- SD maximal dimension of the mucosal lesions was 6.40 +/- 2.19 mm (range 3 - 10). Mean number of forceps biopsy fragments was 3.80 +/- 1.96 and mean sampling ratio was 2.08 +/- 1.07 mm/fragment. Before resection, histological findings from forceps biopsy were: 13 low grade dysplasias (65.0 %), 2 high grade dysplasias (10.0 %), and 5 intramucosal carcinomas (25.0 %). CONCLUSIONS: In the case of pathologically negative findings at EMR, tumors might have been small enough to have been removed by the previous forceps biopsy. However, the possibility of sampling error or of a different location should be considered. Furthermore, appropriate communication between endoscopists and pathologists is essential.
E S Kim; S W Jeon; S Y Park; Y D Park; Y J Chung; S J Yoon; S Y Lee; J Y Park; H I Bae; C M Cho; W Y Tak; Y O Kweon; S K Kim; Y H Choi
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Publication Detail:
Type:  Journal Article     Date:  2009-08-19
Journal Detail:
Title:  Endoscopy     Volume:  41     ISSN:  1438-8812     ISO Abbreviation:  Endoscopy     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-09-11     Completed Date:  2009-12-01     Revised Date:  2010-04-28    
Medline Journal Info:
Nlm Unique ID:  0215166     Medline TA:  Endoscopy     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  739-45     Citation Subset:  IM    
Copyright Information:
Copyright Georg Thieme Verlag KG Stuttgart. New York.
Department of Internal Medicine, Division of Gastroenterology and Hepatology, Kyungpook National University Hospital, Daegu 700-721, Korea.
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MeSH Terms
Adenocarcinoma / microbiology,  pathology
Diagnostic Errors*
Dissection / methods
Endoscopy, Gastrointestinal* / methods
Gastric Mucosa / pathology*,  surgery
Helicobacter pylori / isolation & purification
Middle Aged
Pyloric Antrum / pathology
Retrospective Studies
Stomach Neoplasms / microbiology,  pathology*
Comment In:
Endoscopy. 2010 May;42(5):429-30; author reply 430   [PMID:  20425670 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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