Abstract
Clinicopathological and endoscopical features of myogenic tumors of the stomach were investigated in 24 patients with leiomyoma (25 lesions) and 12 with leiomyosarcoma (12 lesions). The diagnosis of these tumors was histologically made by examining the resected specimens. Sixty-five percent of leiomyomas were less than 5.0 cm in longest diameter, whereas 75% of leiomyosarcomas were more than 5.0 cm in longest diameter. Crater of the tumor was more frequent in leiomyosarcoma than in leiomyoma : 50% of leiomyosarcomas had craters, whereas only 24% of leiomyomas had craters. In 4 patients tumor growth was endoscopically observed by follow-up examinations, and 3 of them were histologically proven to be a leiomyosarcoma. These findings indicate that tumor size, crater formation and tumor growth were useful to differentiate leiomyosarcomas from leiomyomas. We developed a new biopsy procedure, aspiration biopsy under direct vision of gastrofiberscope, using a heparinized fine-needle. By this procedure, correct diagnosis could be cytologically made in 4 out of 5 patients with leiomyosarcoma. This procedure was useful for cytological diagnosis of gastric myogenic tumors.
