Gastric Protruded Lesions Diagnosed As GroupⅢ by Biopsy: Diagnostic Problems from the Endoscopical Point of View Kazuo Hayakawa 1 1Department of Gastroenterology, Toranomon Hospital Keyword: GroupⅢ , Ⅱa-subtype , 異型上皮巣 , 生検診断 , 内視鏡的胃粘膜切除 pp.927-939
Published Date 1990/8/25
DOI https://doi.org/10.11477/mf.1403111327
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 We discussed here about the problems associated with gastric protruded lesions histologically diagnosed as GroupⅢ by biopsy. Comparison was made between endoscopic and histologic findings of 53 lesions in which definitive histological diagnosis was made on surgical specimens or endoscopically resected materials obtained from 224 protruded lesions initially diagnosed as GroupⅢ by biopsy. Of those 53 lesions 36 lesions (67.9%) were histologically diagnosed as atypical epithe-lium including Ⅱa-subtype, while the remaining 17 (32.1%) were carcinoma. Carcinoma was of well differentiated type in all these 17 lesions. It was speculated that initial biopsy specimens were not large enough for detecting carcinoma. Most of the lesions of atypical epithelium including Ⅱa-subtype were endoscopically diagnosed or suspected as Ⅱa-subtype, while 30% of carcinoma lesions were difficult to endoscopically differentiate from Ⅱa-subtype lesions and the remaining 65% exhibited f findings somewhat different from Ⅱa-subtype and were justifiably suspected as carcinoma.

 Thus, faced with the lesion diagnosed as GroupⅢ by biopsy, it would be recommended that the patient be followed-up in case of Ⅱa-subtype considered either endoscopically or histologically, and that biopsy be repeated in case of endoscopically suspected carcinoma. When the repeated biopsy fails to lead the definitive diagnosis, endoscopic resection should be performed.

Copyright © 1990, Igaku-Shoin Ltd. All rights reserved.


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