Background: A subepithelial lesion of the gastrointestinal tract is an elevated lesion, mass or bulge within the lumen that is usually covered by normal-appearing mucosa. Subepithelial lesions were previously described as submucosal tumors.
Aim and objectives: This study aims to clarify the usefulness of the EUS in differential diagnosis of upper gastrointestinal sub epithelial lesions in Egyptian patients.
Subjects and methods: This prospective analytical study that was conducted at the gastroenterology department of Al-Azhar University Hospitals and Theodor Bilharz Research Institute on 60 cases with sub epithelial lesions that incidentally discovered during upper gastrointestinal endoscopy throughout the duration of the study, which was 6 months from march 2023 to September 2023,and those patients who met the inclusion criteria were biopsied by the endoscopist and the biopsies were sent for histopathology analysis, Later we compared the diagnosis reached by EUS and pathology to identify the diagnostic accuracy of EUS.
Results: showed that 40 out of 60 cases examined by EUS biopsy was done while the remaining 20 cases biopsy was not indicated with a diagnosis of lipoma (n=9), pancreatic rest (n=6), and duplication cyst (n=5). In the 40 biopsied cases, the EUS diagnosis was confirmed in all cases except 4 cases, three were diagnosed by EUS as Gastrointestinal stromal tumor (GIST) and turned to be Leiomyoma by pathology, and one case was diagnosed by EUS as Leiomyoma and turned to be GIST by pathology. So, a total GIST of 19 and a total Leiomyoma of 15 were finally diagnosed by pathology.
Conclusion: EUS is a very important modality in the diagnosis of various SELs. Its diagnostic accuracy has been proven by multiple studies including our study. However, it has its limitations, as it is mainly operator dependent and its relatively high cost and scarcity. The need for unifying EUS as a crucial step when confronting SEL since it can reveal critical data about the nature of SEL.