PMC5116173_01
A 54-year-old woman with melena and severe anemia. A, Transverse gray-scale sonography of the epigastrium in the supine position shows a hyperechoic polypoid mass (arrows) in the gastric antrum lumen (asterisks), which is covered by thickened hypoechoic mucosa (open arrows) except for the right lateral side (arrowhead), suggesting denuded mucosa; B, On transverse gray-scale sonography of the epigastrium in the right lateral decubitus position, the mass (arrows) prolapsed toward the duodenum, indicating a pedunculated morphology.
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Systems, Bothell, WA, USA). Sonography revealed a hyperechoic polypoid mass with a size of approximately 4 x 2 cm, mostly covered by thickened hypoechoic mucosa (Figure 1A), which was confirmed microscopically. The mass prolapsed to some extent toward the duodenum when the patient's position changed from supine to right lateral decubitus (Figure 1B), suggesting a pedunculated morphology.
Contrast-enhanced axial CT imaging reveals an intraluminal polypoid mass in the distal antrum of the stomach with central fatty attenuation (arrows), which is covered by thickened hyper-attenuating mucosa (open arrows), except for a denuded mucosal portion (arrowhead). Note the protrusion of the mass into the duodenum.
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Contrast-enhanced CT was performed to identify obscure bleeding in the upper gastrointestinal tract, and revealed an intraluminal polypoid mass measuring approximately 4 x 2 cm in the posterior wall of the distal gastric antrum and protruding into the duodenum (Figure 2).
A, The cut surface of the gross specimen of the mass reveals a lobulating contoured polypoid mass with a whitish-yellow solid area. Some portion of the overlying mucosa is denudated (arrowheads); B, On photomicrograph (H & E staining, original magnification, x100), the mass was composed of mature adipose tissue with irregularly-shaped blood vessels (open arrowheads) and loose connective tissue.
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The cut surface of the mass revealed lobulated contours with a whitish-yellow solid area, as well as focally denuded mucosa (Figure 3A). Microscopically, most of the mass was located in the submucosal layer and was composed of mature adipose tissue with irregularly-shaped blood vessels and loose connective tissue (Figure 3B).