1989 Volume 31 Issue 8 Pages 2078-2088_1
There is a distinct benign clinical entity called heterotopic submucosal gastric cysts and association of these cysts with carcinoma of the stomach has been suggested. However, its difficulty in predicting the existence of such cysts preoperatively has resulted in a lot of surgical resection with mistaken diagnosis. Four surgically resected cases with preoperative endoscopic ultrasonography (EUS) were studied. In three of these superficial depressed type of early cancer was noted simultaneously. The clinical feature of these cysts on EUS was characterized by multiple small cystic areas, which were less than 2cm in diameter and located in the superficial hypoechoic portion of the 3rd layer of the stomach with preserved wall distensibility. Histopathologically, heterotopic glands with dilated grandular cysts were seen in the superficial layer of the submucosa. In one case which was associated with gastric cancer, these cysts could be accurately diagnosed by EUS even when an irregular mucosal surface mimicked the invasion of the neoplasm. EUS is useful for clinical diagnosis of the heterotopic submucosal cysts and differentiation of these cysts from other types of gastric cysts.
