Diagnostic Value of Endoscopic Ultrasound-Guided Fine Needle Biopsy in Detecting Diffuse Gastric Carcinoma- A case report

Diffuse gastric carcinoma is a rare disease entity, frequently characterized by an early age of onset and a poor prognosis. The aim of this case presentation was to emphasize the role of endoscopic ultrasound guided fine needle biopsy (EUS-FNB) in patients with diffuse gastric carcinoma and negative endoscopic biopsy findings.We present the case of a 47-year-old woman admitted to our hospital with a three-month history of postprandial vomiting, dysphagia related to solid foods, and loss of appetite, resulting in weight loss. Before admission in the hospital she performed several upper endoscopies that revealed a narrow gastric lumen. Repeated conventional biopsies were performed but the histopathological results were negative for malignancy. In the current admission EUS-FNB using a 22-gauge Franseen-tip core biopsy needle was performed. Under EUS guidance we observed a thickened gastric wall of 1.1 cm mainly with a thickened submucosa and muscle layer. EUS-FNB with three passes was performed from the thickened gastric wall. The histopathological examination revealed the presence of poorly cohesive diffuse gastric carcinoma with signet-ring cell G3. The patient was referred to the surgery department were a total gastrectomy followed by esophagojejunostomy with roux-en-Y reconstruction was performed. In conclusion EUS-FNB might contribute to the accurate diagnosis of diffuse gastric carcinoma in cases where standard endoscopic biopsy fails to confirm malignancy.

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Artikel online veröffentlicht:
27. März 2025