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Detection of early scirrhous carcinoma of the stomach by endoscopic ultrasonography

The Third Department of Internal Medicine, Faculty of Medicine, Kyushu University, Maidashi 3–1–1, Higashi-ku, Fukuoka 812, Japan

Correspondence: Address correspondence to Hiroshi Fujishima, MD, Fujishima Clinic, 10–10 Kinan-chou, Tokuyama 745, Japan.

The endoscopic ultrasonography (US) characteristics of early scirrhous carcinoma of the stomach (ESS) were evaluated in four patients. ESS was defined as the presence of poorly differentiated carcinoma cells spreading through the submucosa and muscularis propria in association with a marked desmoplastic reaction without serosal invasion. ESS was characterized by localized irregular hypoechoic enlargement of the third (sub-mucosal) and the fourth (muscularis propria) layers. The fifth (serosal) layer was normal. The third and fourth layers showed a threefold increase in thickness compared with the thickness of these layers in healthy subjects. Our results suggest that endoscopic US is useful for diagnosis of ESS.

Received for publication December 11, 1995. Revision received March 25, 1996. Accepted for publication April 3, 1996.