PMC5753916_01
Abdominal CT scan with contrast shows an ill-defined mass below the gastro duodenal junction.
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Abdominal computed tomography (CT) scan with contrast (Figure 1) showed an ill-defined mass below the gastro duodenal junction, mural-based heterogeneous with multiple calcified foci, not associated with liver lesions, peritoneal spread or metastatic lymph nodes.
Gross photo of a fairly well-circumscribed gastric mass.
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The resection specimen demonstrated a fairly well-circumscribed, multilobular mass measuring 7.5 x 4.5 x 3.5 cm (Figure 2), arising from the posterior gastric wall.
Histopathology of a gastric gastrointestinal stromal tumor (hematoxylin and eosin stain): (a and b) (arrow head), multiple areas of calcification with osseous differentiation and mature bone formation (H and E stain; magnification x10), (c) mixed growth patterns of both epithelioid and spindle cells (H and E stain; magnification x20) and (d) low mitotic count, less than 3/50 HPF (H and E stain; magnification x40).
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Histopathological examination (Figure 3) revealed diffuse sheets of mixed pattern spindle and epithelioid cells with focal multinodular/plexiform growth pattern.
Immunohistochemistry of gastric gastrointestinal stromal tumor: (a) tumor cells are showing diffuse positivity for DOG1 (immunohistochemistry stain; magnification x20) and (b) tumor cells are showing positive staining for CD117 (immunohistochemistry stain; magnification x20).
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By immunohistochemistry, the tumor cells were positive for DOG1 (Figure 4(a)) and CD117 (Figure 4(b)), with focal immunoreactivity against CD34.