Clin Endosc.  2021 Nov;54(6):935-936. 10.5946/ce.2020.164.

Endoscopic Submucosal Dissection of an Inverted Pyloric Gland Adenoma Using Dental Floss and Clip Traction

• Kim GH
• Lee MW
• Lee BE
• Park DY

• KMID: 2522718
• DOI: http://doi.org/10.5946/ce.2020.164

Figure

• 

  Fig. 1. (A) A reddish elevated lesion with a diameter of 1.5 cm and an opening on the greater curvature of the gastric upper body. (B) Endoscopic ultrasonography of the lesion showing a downward papillary growth into an anechoic cystic space of approximately 2 cm in size in the deep mucosal and submucosal layers. (C) During endoscopic submucosal dissection, the dissection plane is secured between the tumor and the proper muscle layer using a clip attached with dental floss. (D) The resected specimen.

• 

  Fig. 2. (A) Histopathological examination showing that the cystic invagination of the mucosal lesion is composed of neoplastic glands with high-grade dysplasia (hematoxylin and eosin stain ×12.5). (B) Most of the glandular cells have round nuclei with prominent nucleoli and mucinous columnar cytoplasm that resemble the pyloric glandular epithelium (hematoxylin and eosin stain ×200).

Reference

1. Golger D, Probst A, Wagner T, Messmann H. Pyloric-gland adenoma of the stomach: case report of a rare tumor successfully treated with endoscopic submucosal dissection. Endoscopy. 2008; 40(Suppl 2):E110–E111.

2. Oberhuber G, Stolte M. Gastric polyps: an update of their pathology and biological significance. Virchows Arch. 2000; 437:581–590.

3. Yamamoto M, Nishida T, Nakamatsu D, Adachi S, Inada M. Endoscopic findings of inverted pyloric gland adenoma resected by endoscopic submucosal dissection. J Gastrointestin Liver Dis. 2018; 27:361.

4. Yoshida M, Takizawa K, Suzuki S, et al. Conventional versus traction-assisted endoscopic submucosal dissection for gastric neoplasms: a multicenter, randomized controlled trial (with video). Gastrointest Endosc. 2018; 87:1231–1240.