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Approach to upper gastrointestinal subepithelial lesions.
Shrihari Anil Anikhindi1, Rajesh Puri2, Noriya Uedo3
1Institute of Liver, Gastroenterology & Pancreaticobiliary Sciences, Sir Ganga Ram Hospital, New Delhi, India.
Expert Review of Gastroenterology & Hepatology
|June 12, 2025
Summary
Subepithelial lesions (SELs) in the upper GI tract require accurate diagnosis due to potential malignancy. Endoscopic ultrasound (EUS) aids in characterizing these lesions, improving patient management and outcomes.
Area of Science:
- Gastroenterology
- Endoscopy
- Oncology
Background:
- Subepithelial lesions (SELs) of the upper gastrointestinal tract originate from deeper layers, presenting diagnostic challenges.
- Accurate diagnosis is crucial as some SELs possess malignant potential.
Purpose of the Study:
- To provide a structured approach for evaluating and managing upper gastrointestinal SELs.
- To discuss key features of common SELs, including GISTs, NETs, lipomas, and leiomyomas.
Main Methods:
- Comprehensive literature review up to December 2024, including MEDLINE search and major society guidelines.
- Emphasis on endoscopic ultrasound (EUS) for lesion characterization and tissue acquisition.
- Analysis of diagnostic methods and clinical features relevant to SELs.
Main Results:
- EUS, especially with tissue sampling, has significantly improved SEL evaluation, enabling earlier diagnosis and risk stratification.
- Key features of common benign and malignant SELs are detailed.
Conclusions:
- EUS is a revolutionary tool for SEL assessment.
- Future advancements in AI, molecular diagnostics, and improved techniques will further enhance SEL management precision and outcomes.
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