Synopsis

Table 3.15 Classification of masses in the stomach

Indentations

Intramural processes Polypoid lesions

Indentations

Intramural processes Polypoid lesions

Sternum

Leiomyoma

Hyperplastic

Liver

Hemangioma

polyp

- Normal

Lipoma

Focal foveolar

liver

Neurofibroma

hyperplasia

- Metastasis

Intramural gastric

Chronic

- Cyst

carcinoma

erosions

Spleen

Leiomyosarcoma

Elster glandular

Pancreas

- All of these

cyst

- Normal

intramural

Adenoma

pancreas

processes are

Ectopic

- Carcinoma

indistinguish-

pancreatic

- Cyst

able by endo-

tissue

Duodenum

scopic examina

Carcinoid

Intraabdom

tion!

Carcinoma

inal metastasis

Lymphoma

Heterotopic

Brunner glands

Fig. 3.90 Location of masses in the stomach a Indentation of the stomach wall by an enlarged spleen

Fig. 3.90 Location of masses in the stomach a Indentation of the stomach wall by an enlarged spleen

b Intramural mass c Polypoid mass, in this case a gastric polyp b Intramural mass c Polypoid mass, in this case a gastric polyp u ru

TO U

Checklist for endoscopic evaluation

- Gastric region (cardia, fundus, body, antrum, prepy-loric area)

- Specific site (lesser curvature, greater curvature, anterior wall, posterior wall)

- in millimeters or centimeters (estimate size with biopsy forceps)

► Shape and relation to substrate (Fig. 3.91)

- Flat, hemispherical, spherical

- Poorly demarcated, sharply demarcated, constricted base, pedunculated

- Pitted, irregular, cauliflowerlike

► Mucosal surface

- Normal-appearing, smooth, mobile

- Abnormal-appearing, reddened, fragile, fissured

- Glassy, glistening

- Ulcerated, eroded

► Relation to gastric wall (requires examination with biopsy forceps)

- Extramural indentation

- Intramural lesion

- Arising from the mucosa

- Mobility of the gastric wall

- Mobility of the mucosa

► Lesion morphology should permit a fairly accurate classification

- Indentation (extramural)

- Intramural lesion

- Polypoid lesion

Fig. 3.91 Nomenclature of polypoid mucosal lesions

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