ABSTRACT
Objective:To report two cases of esophageal granular cell tumor treated by endoscopic submucosal dissection,and to improve the clinical awareness of the disease.Methods:The results of endoscope and ultrasonography endoscope of 2 cases were retrospectively analyzed.A preliminary diagnosis of the 2 cases was esophageal submucosal protruded lesion.The patients underwent endoscopic submucosal dissection and the tumors were removed completely.Firstly,the lesion border was marked and then hyaluronic acid was injected into submucosa to uplift the lesion sufficiently.Secondly,the mucosa was circumferentially incised along the marked points,and then the lesion was dissected along the submucosal layer gradually to the whole.Finally,necessary hemostatic was undertaken and the wound was clipped with titanium.Results:The pathological results after operation represented that the cells were polygonal or fusiform,rich in cytoplasm and had a dichromatic granular substance,and the nuclei were small.The immunohistochemical results showed S-100 (+),NSE (+) / (-),CK (-),SMA (-),CD117 (-),desmin (-) and proved that 2 cases of tumors were esophageal granular cell tumor.Two patients recovered smoothly after operation.They underwent endoscopic examination 16 months after operation,and no local recurrence or metastasis was founded.Conclusion:Endoscopic submucosal dissection is a safe and effective treatment of esophageal granular cell tumor,and the postoperative prognosis is good.
ABSTRACT
Objective:To report two cases of esophageal granular cell tumor treated by endoscopic submucosal dissection,and to improve the clinical awareness of the disease.Methods:The results of endoscope and ultrasonography endoscope of 2 cases were retrospectively analyzed.A preliminary diagnosis of the 2 cases was esophageal submucosal protruded lesion.The patients underwent endoscopic submucosal dissection and the tumors were removed completely.Firstly,the lesion border was marked and then hyaluronic acid was injected into submucosa to uplift the lesion sufficiently.Secondly,the mucosa was circumferentially incised along the marked points,and then the lesion was dissected along the submucosal layer gradually to the whole.Finally,necessary hemostatic was undertaken and the wound was clipped with titanium.Results:The pathological results after operation represented that the cells were polygonal or fusiform,rich in cytoplasm and had a dichromatic granular substance,and the nuclei were small.The immunohistochemical results showed S-100 (+),NSE (+) / (-),CK (-),SMA (-),CD117 (-),desmin (-) and proved that 2 cases of tumors were esophageal granular cell tumor.Two patients recovered smoothly after operation.They underwent endoscopic examination 16 months after operation,and no local recurrence or metastasis was founded.Conclusion:Endoscopic submucosal dissection is a safe and effective treatment of esophageal granular cell tumor,and the postoperative prognosis is good.
ABSTRACT
Objective To evaluate the effect of pre-cut-endoscopic mucosa resection of colorectal laterally spreading tumor. Methods 65 patients with LST were enrolled from January 2014 to February 2014. LST was detected by chromoendoscopy and NBI combined with magnifying endoscopy technique. The size, site, morphological features, were observed and the histopathological features of the specimen of LST was analyzed. All the 65 LSTs were resect by pre-cut-EMR. The clinical results including enbloc resection rate, all bloc resection rate, procedure time, complication and recurrence rates were retrospectively evaluated. Results All the 65 LSTs lesions ranged from 2.0 cm to 5.0 cm, with a mean diameter of (2.4 ± 1.7) cm. The site of 65 LSTs was in rectum 28 (43.1 %), 11 LSTs in sigmoid colon (16.9 %), 6 LSTs in descending colon (9.2 %), 2 LSTs in splenic flexure of colon (3.1 %), 9 LSTs in transverse colon (13.8 %), 4 LSTs in Hepatic flexure of colon (6.2 %), 2 LSTs in ascending colon(3.1 %), and 3 LSTs in cecum (4.6 %). Morphology of 23 LSTs were homogeneous granular type (35.4 %), 27 LSTs were mixed non-granular type (41.5 %), 13 LSTs were flat elevated type (20.0 %), and 2 LSTs were pseudo-depressed type (3.1 %). The histopathological diagnoses of LST included 12 tubular adenoma (18.5 %), 19 villous-tubular adenoma (29.2 %), 26 villous adenoma (40.0 %), 7 advanced intraepithelial tumor (10.7 %), 1 intramucosal carcinoma (1.5 %). Enbloc resection was achieved in 65 patients (100.0 %) with a mean operation time of (18.0 ± 11.7) min. 5 cases were bleeding during the operation (7.7 %), 1 case was bleeding 7 days after operation (1.5 %), no perforation was happened. 65 patients were followed up for 3 ~ 12 months, and no local recurrence was found. Conclusion Pre-cut-endoscopic mucosal resection an effective and safe therapy for colorectal LST larger than 2.0 cm.