Li Qing-Qing, Liu Dong
Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
World J Clin Cases. 2022 Feb 16;10(5):1667-1674. doi: 10.12998/wjcc.v10.i5.1667.
Gastric origin tumors were diagnosed and evaluated preoperatively by gastroscopy, endoscopic ultrasonography, computed tomography (CT) or magnetic resonance imaging. Currently, transabdominal high-resolution ultrasound combined with gastrointestinal contrast agent can be used to diagnose stomach tumors effectively and without invasive procedures or radiation. However, although an appreciable number of cases of gastric schwannoma (GS) have been reported since the first description of such in 1988, the ongoing lack of a comprehensive list of ultrasonic characteristics has limited the accuracy of preoperative ultrasound diagnosis.
A 64-year-old female patient presented to our hospital with dizziness and head discomfort. During an abdominal ultrasound, a hypoechoic gastric mass was found, having clear and regular boundaries and no observable blood flow. Based on these characteristics, a gastrointestinal stromal tumor was suspected. Results from an endoscopic ultrasound biopsy and accompanying immunohistochemical analysis, coupled with abdominal CT findings indicating lymph node enlargement around the stomach, led to diagnosis of GS but did not exclude malignancy. After surgical resection of the tumor, the final diagnosis of GS without lymph node metastasis was made. No recurrence has occurred in the 6 years of follow-up.
A clearly defined ultrasonic characteristic profile of GS is important to improve diagnostic accuracy.
胃源性肿瘤术前通过胃镜、超声内镜、计算机断层扫描（CT）或磁共振成像进行诊断和评估。目前，经腹高分辨率超声联合胃肠道造影剂可有效诊断胃肿瘤，且无需侵入性操作或辐射。然而，自1988年首次描述胃神经鞘瘤（GS）以来，尽管已有相当数量的病例报道，但目前仍缺乏全面的超声特征列表，这限制了术前超声诊断的准确性。
一名64岁女性患者因头晕和头部不适前来我院就诊。腹部超声检查发现胃内有一个低回声肿块，边界清晰规则，未见明显血流信号。基于这些特征，怀疑为胃肠道间质瘤。超声内镜活检及相关免疫组化分析结果，结合腹部CT显示胃周围淋巴结肿大，最终诊断为GS，但不排除恶性可能。肿瘤手术切除后，最终诊断为无淋巴结转移的GS。随访6年未复发。
明确GS的超声特征对提高诊断准确性很重要。
