Endoscopic ultrasonography in the study of extramucosal swellings in the upper digestive tract

The authors performed an echoendoscopic examination of 91 patients who, at a previous endoscopy, had presented extramucosal swellings in the upper digestive tract. On this occasion, the images were suggestive of a leiomyoma in 73 cases, a schwannoma in 3, an ectopic pancreas in 1, and a cyst of the gastric wall in 1. There was an extrinsic compression of the tract by an adjacent organ in three cases and by an adenopathy in two others. In six patients the authors were unable to make an echographic identification of the swellings noted upon endoscopy as they noted no echographic alteration. The echoendoscopic examination was considered normal. Given that most of these patients did not undergo surgery, the authors were only able to obtain a histological examination of surgically removed tissue in 11. The diagnosis was confirmed in eight cases. In one patient in which it proved impossible to pass the endoscope through the stenotic area, the histological examination did not confirm the echography: In two others, classified as leiomyomas, the histology showed leiomyosarcomas.