By Frank Slaby
Reports crucial anatomy through physique sector for nationwide forums evaluation.
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Example text
B EUS appearance suggestive of benign submucosal mass of the muscularis propria. Follow-up is underway the digestive tract. There is a good correlation between EUS images and the anatomy of the wall of the digestive tract (Fig. 15). Although there are some differences in relation to the tract examined, at EUS the intestinal wall appears to be composed of five distinct echogenic layers, char- acterized by the alternation of images with hyperechoic and hypoechoic appearance, which internally-to-externally are as follows: – the interface between the mucosa and the organ lumen (hyperechoic layer); – the deep mucosa (hypoechoic layer); 34 P.
The differential diagnosis includes benign and malignant, primary and secondary tumors. Benign masses include first of all lipomas and adenomas. Lipomas are preferentially located in the ileum; b appear as ‘filling defects’ oval or round in shape, sharply defined, sessile or pedunculated. They are generally deformable following the physiologic activity of intestinal peristalsis and upon targeted compression during radiological examination. Adenomas may also appear as "filling defects" and display a broad base, with a homogeneous or irregular “cauliflower” appearance and radiolucent bands (‘soap bubble’ appearance described by Waters in 1930) [1, 3-6].
A b Fig. 5 a, b Leiomyoma on the posterior wall of the of the gastric body. Note the typical features of a submucosal mass (arrow) a with the gastric lumen, containing air or with airfluid levels, and in which intraluminal contrast material may accumulate [4]. The differential diagnosis of course includes other mesenchymal tumors such as leiomyomas, leiomyosarcomas, schwannomas, neurofibromas and neuroendocrine tumors (such as solitary gastric carcinoids). However, leiomyomas, leiomyosarcomas and schwannomas are relatively rare in the tract considered, b Fig.