Large gastric folds evaluated by endoscopic ultrasonography

Diffuse large gastric folds may lead to difficult clinical diagnosis particularly in biopsy-negative cases. In the differential diagnosis Menetrier's disease or hypertrophic gastritis and linitis, EUS is very helpful because of its ability in imaging the location of mural abnormality. In initially negative biopsy for linitis, EUS can help the clinician in selecting the optimal site for positive biopsy. In gastric NHL, EUS can be helpful in selecting the appropriate candidate for surgery and in monitoring the response to chemotherapy and irradiation. EUS appears to be more suitable for TNM staging than the Ann Arbor classification for gastric NHL. The routine use of EUS-guided FNA should be attempted for obtaining the tissue diagnosis.