Table 5.
Cases with Incorrect Diagnosis by EUS
| Patient No. | EUS finding | Evaluated vessel | Vascular invasion | Distance between tumor and vessel (μm) | Tumor location | Tumor size (mm) | Histological type |
|---|---|---|---|---|---|---|---|
| 1 | Type 2 | SMV | (–) | 742 | Ph (neck) | 55 | por |
| 2 | Type 2 | SMV | (–) | 96 | Ph (neck) | 33 | tub2 |
| 3 | Type 2 | SMV | (–) | 0a) | Pt | 65 | muc |
| 4 | Type 2 | SPA | (–) | 623 | Pb | 30 | tub2 |
| 5 | Type 2 | SPA | (–) | 0a) | Pt | 45 | tub2 |
| 6 | Type 2 | SMA | (–) | 854 | Ph (neck) | 25 | tub2 |
| 7 | Type 3 | PV | (+) | - | Ph | 26 | tub2 |
| 8 | Type 3 | PV | (+) | - | Ph | 45 | tub1 |
| 9 | Type 3 | SPA | (+) | - | Pt | 65 | muc |
Type 2: Loss of the extra-hyperechoic layer (positive invasion).
Type 3: Existence of the extra-hyperechoic layer of the vessel (negative invasion).
EUS, endoscopic ultrasonography; muc, mucinous adenocarcinoma; por, poorly differentiated adenocarcinoma; PV, portal vein; SMA, superior mesenteric artery; SMV, superior mesenteric vein; SPA, splenic artery; tub, tubular adenocarcinoma.
a)
Although the tumor cells were neighboring to the vascular walls, no invasion was detected with Elastica Van Gieson staining.