• Title/Summary/Keyword: Subepithelial

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A Case of Mucous Membrane Pemphigoid: From Diagnosis to Therapeutic Strategy

  • Kang, Kun-Hwa;Byun, Jin-Seok;Jung, Jae-Kwang;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • v.46 no.2
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    • pp.63-68
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    • 2021
  • Mucous membrane pemphigoid (MMP) is a heterogeneous group of chronic, autoimmune subepithelial blistering diseases, predominantly involving oral mucosal membrane. Because of its pathophysiology of autoimmune reaction, MMP-related gingivitis would not respond to conventional periodontal treatments. We present a case of a 65-year-old female with a chief complaint of chronic generalized buccal gingivitis, unimproved after periodontal treatment for four months. Based on the clinical findings, histological examination, and direct immunofluorescence microscopy, it was diagnosed as MMP. The symptoms were relieved with immunomodulatory therapy using corticosteroids and the supportive management of professional plaque control. MMP can cause pathological involvement throughout the oral and other mucosae of the body, thus leading to functional impairment through repeated inflammatory cascades. Therefore, accurate diagnosis is essential to properly manage local and possible systemic complications of MMP.

Socket sealing using pedicle subepithelial connective tissue graft with tunneling in maxillary esthetic zone: Case reports

  • Bae, Ju-Eun;Kim, Yong-Gun;Park, Jin-Woo;Lee, Jae-Mok;Suh, Jo-Young
    • Oral Biology Research
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    • v.42 no.4
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    • pp.254-261
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    • 2018
  • Reports have it that horizontal and vertical loss of the ridge happens during 6 months after tooth extraction. So valuable ridge preservation techniques are often necessary in the maxillary anterior areas. Maintaining and/or increasing blood supply and stability is essential to graft survival. The objective of this study was to determine the effect on extraction socket seal of pedicle subepithelial connective tissue graft with tunneling on maxillary esthetic zone through healing state for 8 weeks.

Submucosal endoscopy: the present and future

  • Zaheer Nabi;Duvvur Nageshwar Reddy
    • Clinical Endoscopy
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    • v.56 no.1
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    • pp.23-37
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    • 2023
  • Submucosal endoscopy or third-space endoscopy utilizes the potential space between the mucosal and muscularis layers of the gastrointestinal tract to execute therapeutic interventions for various diseases. Over the last decade, endoscopic access to the submucosal space has revolutionized the field of therapeutic endoscopy. Submucosal endoscopy was originally used to perform endoscopic myotomy in patients with achalasia cardia, and its use has grown exponentially since. Currently, submucosal endoscopy is widely used to resect subepithelial tumors and to manage refractory gastroparesis and Zenker's diverticulum. While the utility of submucosal endoscopy has stood the test of time in esophageal motility disorders and subepithelial tumors, its durability remains to be established in conditions such as Zenker's diverticulum and refractory gastroparesis. Other emerging indications for submucosal endoscopy include esophageal epiphrenic diverticulum, Hirschsprung's disease, and esophageal strictures not amenable to conventional endoscopic treatment. The potential of submucosal endoscopy to provide easy and safe access to the mediastinum and peritoneal spaces may open doors to novel indications and rejuvenate the interest of endoscopists in natural orifice transluminal endoscopic surgery in the future. This review focuses on the current spectrum, recent updates, and future direction of submucosal endoscopy in the gastrointestinal tract.

Gastric Follicular Lymphomas Presenting as Subepithelial Tumors: Two Cases (위 상피하 종양으로 발견된 소포림프종 2예)

  • Kim, Hyeong Jin;Choi, Cheol Woong;Park, Su Bum;Kim, Su Jin
    • The Korean journal of helicobacter and upper gastrointestinal research
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    • v.18 no.4
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    • pp.258-263
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    • 2018
  • Follicular lymphoma is the most common form of low-grade B cell lymphoma. Follicular lymphoma occurs predominantly at lymph node sites and rarely in the gastrointestinal tract. Rare gastrointestinal follicular lymphoma is most commonly found in the small intestine, especially in the duodenum, and appears as multiple granules. However, gastric follicular lymphoma mostly appears as a subepithelial tumor. We observed two primary gastric follicular lymphomas that resembled subepithelial tumors located in the body of the stomach. Endoscopic ultrasound revealed hypoechoic lesions located in the submucosa layer. Since endoscopic forceps biopsies were inconclusive, we performed endoscopic submucosal dissection, which resulted in a final pathologic diagnosis of follicular lymphoma. Because of the indolent nature of gastrointestinal follicular lymphoma, the "watch and wait" strategy can be applied in the early phase. The identification of endoscopic characteristics of gastric follicular lymphoma can be helpful for differential diagnosis and decision of treatment strategy. Therefore, we report two cases of primary gastrointestinal follicular lymphoma diagnosed following endoscopic submucosal dissection.