PMC5018075_01
(a) Endoscopy showed an 8.0-cm protuberant lesion with ulcer on the greater curvature of the gastric body. (b) Magnifying narrow-band imaging endoscopy revealed the abnormal mucosal microstructure in the discolored protrusion (white arrows). (c) Endoscopic ultrasonography showed a hypoechoic mass deriving from the submucosal layer.
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Gastrointestinal endoscopy showed an 8.0-cm submucosal tumor with ulcer on the greater curvature of the gastric body (Fig. 1a). Magnifying narrow-band imaging endoscopy revealed the abnormal mucosal microstructure in the discolored protrusion (Fig. 1b). Examination by color Doppler endoscopic ultrasonography showed the hypoechoic mass with hypervascularity arising from the submucosal layer (Fig. 1c).
(a, b) Axial and coronal images of CT showed focal wall thickening with hyperenhancement on the greater curvature of the stomach (white arrows).
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Abdominal computed tomography (CT) revealed focal wall thickening with hyperenhancement on the greater curvature and no sign of any lymph node swelling (Fig. 2a, b).
(a, b) The resected tumor was 8.0 x 6.5 cm in size. The tumor was ash white and elastic hard with the presence of a seroma component.
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Histological examination revealed serosa-exposed plasmacytoma of the stomach with 4 out of 15 lymph nodes metastasis. (Fig. 3a, b).
(a) Microscopic examination (hematoxylin-eosin staining, original magnification x 400) revealed numerous plasma cells infiltrating the serosa of the stomach. (b) Immunohistochemical staining of the tumor cells for CD138 showed positive results.
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The immunohistological findings showed that the tumor cells were negative for CD20, CD79a, CD3, and cyclin D1, and positive for CD138 (Fig. 4a, b).