31. Figure 44–8. Endoscopic ultrasonography (EUS) of gastric tumors. A , The five layers of the gastric wall may be discerned near the bottom of the image, from the 3 o'clock position to the 6 o'clock position ( open arrowhead ). The tumor (TUMOR, solid arrowhead ) involves the fourth hypoechoic (dark) layer, the muscularis propria, but has not encroached on the fifth hypoechoic layer, the serosa. In addition, an enlarged lymph node (LN) at the 6 o'clock position appears to be involved. The patient was found to have a T2N1 tumor. B , A gastric polypoid mass (POLYP, arrowhead ) is pedunculated and involves only the first hyperechoic layer, the superficial mucosa, and has not breached deeper layers, including the muscularis propria (MP). The patient was found to have a benign, 1.5-cm pedunculated hyperplastic polyp. C , The tumor (*) has breached all five layers of the gastric wall, including the fifth hyperechoic (bright) layer and beyond ( arrowhead ). The patient was found to have a T4 tumor. D , Diffuse, hypoechoic infiltrations throughout all five layers of the gastric wall, giving a blotchy moth-eaten appearance ( arrowheads ), and four round, sharply demarcated hypoechoic lymph nodes (LN) are seen. The patient was found to have a stage IIE1 gastric lymphoma. (Courtesy of Markus Goldschmeidt, MD.)
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.
52.
53.
54.
55.
56.
57.
58.
59.
60.
61.
62.
63.
64. “ La medicina sin humanidad, no merece ser ejercida”
![Neoplasias gástricas ,[object Object],[object Object],[object Object]](https://image.slidesharecdn.com/neoplasiasgastricasheeppregrado-111021120948-phpapp02/85/Neoplasiasgastricas-heep-pregrado-1-320.jpg)
![Generalidades ,[object Object],[object Object]](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)