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Sonographically Guided Percutaneous Biopsy of Gastrointestinal Tract Lesions

Santiago F. Marco-Doménech1, Santiago Gil-Sánchez2, Pilar Fernández-García1, Pedro De La Iglesia-Carreña2, Manuel Gonzalez-Añón3, Juan J. Arenas-Jimenez2, Sergio Alonso-Charterina2 and Rosa M. Piqueras-Olmeda1

1 Department of Radiology, Hospital General de Castellón, Avda. de Benicasim, s/n, 12004, Castellón, Spain.
2 Department of Radiology, Hospital General Univeritario de Alicante, Pintor Baeza, s/n, 03010, Alicante, Spain.
3 Department of Radiology, Hospital de la Ribera, Ctra Alzira-Corbera, Km 1, 46600 Alzira (Valencia), Spain.



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Fig. 1A. 14-year-old girl with infantile achalasia and mediastinal mass due to muscular hypertrophy. CT scan shows 7-cm mass in posterior mediastinum with oral contrast media inside (arrow), representing esophagus with thickened wall.

 


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Fig. 1B. 14-year-old girl with infantile achalasia and mediastinal mass due to muscular hypertrophy. Right posterior paravertebral approach sonogram shows pseudokidney sign due to concentric wall thickening of esophagus. Note needle tip in hypoechoic rim (arrows).

 


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Fig. 2A. 69-year-old man with adenocarcinoma of gastroesophageal junction. CT scan shows marked eccentric thickening of gastroesophageal junction (arrows). Note bulky protruding appearance of adenocarcinoma.

 


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Fig. 2B. 69-year-old man with adenocarcinoma of gastroesophageal junction. Transverse sonogram shows eccentric wall thickening in region of gastroesophageal junction (pseudokidney sign) (arrows).

 


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Fig. 2C. 69-year-old man with adenocarcinoma of gastroesophageal junction. Sagittal sonogram of lesion illustrates thickened wall. Note needle tip in lesion (arrow).

 


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Fig. 3A. 71-year-old man with incidental gastric mass due to gastric leiomyoma. CT scan shows round and well-defined mass in anterior wall of gastric antrum (arrows).

 


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Fig. 3B. 71-year-old man with incidental gastric mass due to gastric leiomyoma. Transverse sonogram shows hypoechoic round well-defined mass. Note needle tip in lesion (arrows).

 


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Fig. 4A. 44-year-old man with ulcerative colitis. CT scan shows marked thickening of wall of sigmoid colon (arrows).

 


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Fig. 4B. 44-year-old man with ulcerative colitis. Sagittal sonogram shows concentric wall thickening of sigmoid colon. Note needle tip in lesion (arrow).

 


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Fig. 5A. 61-year-old man with abdominal pain, asthenia, weight loss, and epigastric mass due to gastric lymphoma. CT scan shows diffuse and asymmetric gastric wall thickening (arrow) with wide lumen containing oral contrast medium.

 


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Fig. 5B. 61-year-old man with abdominal pain, asthenia, weight loss, and epigastric mass due to gastric lymphoma. Transverse sonogram shows hydronephrotic pseudokidney sign: circumferentially thickened hypoechoic gastric wall with hyperechoic mucosal surface associated with distended lumen. Note needle tip (arrows). (Reprinted from [4])

 

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