Role of Endoscopic Ultrasonography in Gastroduodenal Cystic Lesions: Pictorial Review

Abstract

1. To know the various gastric and duodenal lesions that may show cystic change. 2. To know the role of endoscopic ultrasonography in the diagnosis of various gastric and duodenal cystic lesions. MDCT may be helpful in the detection of subepithelial lesions. However, differentiation of subepithelial lesions on MDCT is still difficult, because many subepithelial lesions show similar image findings. However, some subepithelial lesions may have cystic change or present as a mainly cystic lesion. MDCT cannot show small cystic changes or differentiate the exact layer of the gastroduodenal wall. Endoscopic ultrasonography may be helpful in detecting small cystic changes within the lesion and identifying the origin of the lesion. Familiarity with gastroduodenal cystic lesions may be helpful in the diagnosis of gastroduodenal subepithelial lesions. 1. If the cyst itself is the main radiologic finding: macrocystic type such as duplication cyst, pancreatic pseudocyst, lymphangioma or bronchogenic cyst. 2. If the cyst is too small to be identified on axial images: microcystic type such as Brunner's gland hamartoma or duodenal cystic dystrophy. 3. If the cyst is present within a solid lesion: solid and cystic type such as GIST or ectopic pancreas. If subepithelial lesions cause symptoms or if a neoplastic condition cannot be excluded on imaging studies, it may be necessary to resect these lesions. Knowledge of the differential diagnosis of various cystic lesions of the stomach and duodenum may promote correct diagnosis and appropriate treatment.