PREOPERATIVE DIAGNOSIS OF MUCINOUS GASTRIC ADENOCARCINOMA BY ENDOSCOPIC ULTRASONOGRAPHY

Objectives: The aims of this study were to investigate the characteris tic features of mucinous gastric carcinoma on endoscopic ultrasonograp hy (EUS) and to demonstrate the usefulness of EUS in the preoperative diagnosis of this disease, Methods: Twelve patients with mucinous gast ric carcinoma who underwent EUS examination between April 1984 and Apr il 1995 were enrolled in this study. All patients subsequently underwe nt surgery, Histopathologically, tumors were classified according to t he mucin content (high or moderate) and the glandular formation of the tumor cells (well or poorly differentiated). Finally, the histologica l and endosonographic features were compared. Results: In all patients , the infiltrated wall appeared echogenic because of diffusely distrib uted, reticular, highly echoic speckles in the submucosa and musculari s propria, The presence of mucinous lakes surrounded by reactive fibro us tissue correlated well with reticular, highly echoic speckles on EU S, There was an increase in echogenicity and thickness of the muscular is propria, depending on the invasion of the mucin, Although the bound ary between submucosa and muscularis propria was distinct and the five -layered gastric wall structure was generally preserved, the mucosal l ayer was not discriminated in patients with poorly differentiated muci nous carcinoma with high mucin content, Conclusions: As a preoperative diagnostic procedure, EUS may be useful in recognizing the mucinous c omponent of gastric tumors and may facilitate the differentiation of m ucinous carcinoma from other gastric epithelial tumors.