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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).
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 diagnosis is mainly established based on the characteristic symptoms. Stomach pain is the most common sign of a peptic ulcer. [12] More specifically, peptic ulcers erode the muscularis mucosae, at minimum reaching to the level of the submucosa (contrast with erosions, which do not involve the muscularis mucosae). [35]
Typically, regions such as the cheeks, lips, and parts of the hard palate contain submucosa (a layer of loose fatty or glandular connective tissue containing the major blood vessels and nerves supplying the mucosa). The submucosa's composition determines the flexibility of the attachment of oral mucosa to the underlying structures.
Deeper invasion into the submucosa will increase the exposure to lymphatics. [8] Long-standing inflammation is a risk factor for the development of cancer. The lamina propria macrophages when under much stress release pro-inflammatory signals that may lead to increased probability of developing cancer.
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.
Pediatric GISTs are treated differently from adult GISTs. Although the generally accepted definition of pediatric GIST is a tumor that is diagnosed at the age of 18 years or younger, [46] "pediatric-type" GISTs can be seen in adults, which affects risk assessment, the role of lymph node resection, and choice of therapy. [48]