PMC4643472_01
Contrast-enhanced computerized tomography showing an exophytic 4 x 3 x 3 cm low-density nodule arising from the posterior wall of the gastric fundus.
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After several upper GI endoscopies showing mild atrophic gastritis in the antrum, had a computerised tomography that revealed a 4 x 3 x 3 cm low-density nodule containing a small focus of calcification arising from the posterior wall of the gastric fundus, suspicious of an exophytic GIST (Fig. 1).
Hyperplasia of muscularis propria (arrows) between main tumour (right) and subserosal nodule (left) highlighted by immunohistochemistry for DOG1.
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There was one separate firm, white nodule measuring 0.8 x 0.7 x 0.4 cm on the serosa and involving the muscularis propria, 3.5 cm from the margin (Fig. 2).
(a) Uninvolved area of muscularis propria; (b) subtle infiltrative component in the muscularis propria contrasted by immunohistochemistry for DOG1.
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There was very subtle diffuse infiltrative component within the muscularis propria, highlighted on the immunohistochemistry for DOG1 and CD117 (Fig. 3).
Microscopic focus of GIST ('tumorlet') away from the main tumour and adjacent to the hyperplasia segment stained with DOG1.
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The tissue immediately adjacent to the staple line contained a further microscopic focus of GIST ('tumorlet') measuring 0.7 x 0.3 mm (Fig. 4).