The Endosonographic Features and Prevalence of Sub-Epithelial Lesions Detected in Upper Gastrointestinal Endoscopy

Sub-epithelial lesions (SELs) discovered during endoscopy may be originated from either layers of the gastrointestinal (GI) tract or outside of the GI lumen. Endoscopic ultrasonography (EUS) is used to identify the source of these lesions and occasionally to obtain a sample.

In this study, we aimed to obtain the prevalence of upper GI SELs along with their ultrasound and pathological features.

In this cross-sectional study, all patients referred to a referral endoscopy department for EUS were enrolled. Size and location of lesions, relevant layer, endosonographic and endoscopic features of the lesions, and definitive pathological diagnoses were collected.

A total of 305 cases were evaluated. 76.32% of SELs had a homogenous echo pattern. The lesions were predominantly seen in the antrum. The lesions were originated from submucosa (37.38%), muscularis propria (33.77%), and deep mucosa (28.85%), respectively. Gastrointestinal stromal tumors (GISTs) (47.54%) were the most common type of SELs. The most prevalent heteroechoic and hyperechoic lesions were pancreatic rest and lipoma (55.8%), respectively.

Most SELs are located in the gastric antrum. Out of all evaluated lesions, GISTs were the most frequent lesion discerned by EUS.