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The submucosa (or tela submucosa) is a thin layer of tissue in various organs of the gastrointestinal, respiratory, and genitourinary tracts. It is the layer of dense irregular connective tissue that supports the mucosa (mucous membrane) and joins it to the muscular layer, the bulk of overlying smooth muscle (fibers running circularly within layer of longitudinal muscle).
Thickening of the gastric folds may be observed by endoscopy or radiography and may aid in the differential diagnosis of many disease processes including: [3] Gastritis The folds become very thick due to inflammation. [7] Peptic ulcer disease Ulcers cause breaks in the mucosa and cause erosion of the sub-mucosa. Zollinger-Ellison syndrome
The submucosa consists of a dense and irregular layer of connective tissue with blood vessels, lymphatics, and nerves branching into the mucosa and muscular layer. It contains the submucous plexus , and enteric nervous plexus , situated on the inner surface of the muscular layer.
The non-lifting sign was first described in 1994 by Yoshiharu Uno and Akihiro Munakata of the Hirosaki University School of Medicine, Japan. [2]In 1999 the same team showed that the presence of a non-lifting sign correlated with the depth of invasion of the submucosa by early colorectal cancers that were being considered for endoscopic resection. [3]
CT scans are often used in the evaluation of abdominal pain and rectal bleeding, and may suggest the diagnosis of ischemic colitis, pick up complications, or suggest an alternate diagnosis. [26] [27] [28] Endoscopic evaluation, via colonoscopy or flexible sigmoidoscopy, is the procedure of choice
Oral submucous fibrosis (OSF) is a chronic, complex, premalignant (1% transformation risk) condition of the oral cavity, characterized by juxta-epithelial inflammatory reaction and progressive fibrosis of the submucosal tissues (the lamina propria and deeper connective tissues).
Dilated submucosal veins are the most prominent histologic feature of esophageal varices. The expansion of the submucosa leads to elevation of the mucosa above the surrounding tissue, which is apparent during endoscopy and is a key diagnostic feature. Evidence of recent variceal hemorrhage includes necrosis and ulceration of the mucosa.
The mucosa-associated lymphoid tissue (MALT), also called mucosa-associated lymphatic tissue, is a diffuse system of small concentrations of lymphoid tissue found in various submucosal membrane sites of the body, such as the gastrointestinal tract, nasopharynx, thyroid, breast, lung, salivary glands, eye, and skin.