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Where has the tumor gone? The characteristics of cases of negative pathologic diagnosis after endoscopic mucosal resection

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Author(s)
E. S. KimS. W. JeonS. Y. ParkY. D. ParkY. J. ChungS. J. YoonS. Y. LeeJ. Y. ParkH. I. BaeC. M. ChoW. Y. TakY. O. KweonS. K. KimY. H. Choi
Keimyung Author(s)
Kim, Eun Soo
Department
Dept. of Internal Medicine (내과학)
Journal Title
Endoscopy
Issued Date
2009
Volume
41
Issue
9
Abstract
Background and study aims: Discrepancies can occur between the histopathological findings from forceps biopsy and endoscopic mucosal resection (EMR), and occasionally in embarrassing cases tumorous tissue is not found at EMR. The aim of the present study was to evaluate the clinical, endoscopic, and histological features of gastric tumors in patients with pathololgically negative findings at EMR.

Patients and methods: We retrospectively reviewed data from all patients with gastric tumor treated with EMR or endoscopic submucosal dissection (ESD) between August 1999 and April 2007 at our institution, and enrolled into the study patients with no tumor tissue found at mucosal resection. Their biopsy and EMR specimen slides were reviewed by a single pathologist. Patient characteristics, including demographic and clinical features, and the endoscopic appearance of mucosal lesions were evaluated.

Results: Out of 633 patients treated with EMR or ESD, 20 patients (3.2 %) were included. The mean ± SD maximal dimension of the mucosal lesions was 6.40 ± 2.19 mm (range 3 – 10). Mean number of forceps biopsy fragments was 3.80 ± 1.96 and mean sampling ratio was 2.08 ± 1.07 mm/fragment. Before resection, histological findings from forceps biopsy were: 13 low grade dysplasias (65.0 %), 2 high grade dysplasias (10.0 %), and 5 intramucosal carcinomas (25.0 %).

Conclusions: In the case of pathologically negative findings at EMR, tumors might have been small enough to have been removed by the previous forceps biopsy. However, the possibility of sampling error or of a different location should be considered. Furthermore, appropriate communication between endoscopists and pathologists is essential.
Keimyung Author(s)(Kor)
김은수
Publisher
School of Medicine
Citation
E. S. Kim et al. (2009). Where has the tumor gone? The characteristics of cases of negative pathologic diagnosis after endoscopic mucosal resection. Endoscopy, 41(9), 739–745. doi: 10.1055/s-0029-1215043
Type
Article
ISSN
0013-726X
Source
https://www.thieme-connect.de/DOI/DOI?10.1055/s-0029-1215043
DOI
10.1055/s-0029-1215043
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/35633
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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