Korean Journal of Gastrointestinal Endoscopy 1997;17(3): 411-415.
증례 : 식도 위장관 ; 초음파내시경검사로 조기위암의 심달도 판정시 오진의 원인이 된 호산구성 농양 1예 ( Case Reports : Esophagus , Stomach & Intestine ; Overestimation of the Depth of Invasion in Early Gastric Cancer due to Eosinophilic Abscess by Endoscopic Ultrasonography )
정인식, 김부성, 박두호, 김상우, 양영상, 최종영, 변병훈, 최상욱, 박영민 (In Sik Chung, Boo Sung Kim, Doo Ho Park, Sang Woo Kim, Young Sang Yang, Jong Young Choi, Byung Hun Byun, Sang Wuk Choi and Young Min Park)
Abstract
Eosinophilic abscess is a rare disease of stomach that consists of many eosinophils in submucosa and muscle layers of stomach. Eosinophilic abscess is usually observed in liver after parasite infestation such as hepatic fascioliasis or in intradermal lesion of pemphigus. A 67-year-old female was admitted due to epigastric pain and indigestion. Endoscopic finding suggested early gastric cancer type IIc with the depth of invasion to mucosal layer at the lesser curvature of lower body. Histologic examination of endoscopic biopsy proved to be signet ring cell type adenocarcinoma. On endoscopic ultrasonography, the tumor was imaged as a slightly elevated mass with 15 mm in diameter. The lesion was localized from the first layer to the fourth layer which correspond to the mucosa and the proper muscle layer, The lesion consisted of low echoic and isoechoic densities. The lower echoic lesion ranging from the third layer to the fourth layer was thought to be necrotic or hemorrhagic portion within the tumor. Subtotal gasterectomy was performed. We compared the endoscopic and endosonographic features with the histologic findings of the resected stomach. Histologic examination showed signet ring cell carcinoma in mucosal layer and eosinophilic abscess in submucosal and proper muscle layer. We concluded that the endosonographic depth of invasion was overestimated because of the eosinophilic abscess. (Korean J Gastrointest Kndosc 17: 411-415, 1997)
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