PMC3690222_01
Coronal (a) and transverse (b) chest, abdominal, and pelvic contrast-enhanced computed tomography (CT) scans: showing a 3.8 x 7.2 x 8.7 cm ill-defined mass, involving gastric fundus and extending into gastric cardia and lower gastroesophageal junction. It was associated with multiple enlarged gastrohepatic lymph nodes. There was no evidence of ascites or retroperitoneal or mesenteric lymphatic metastases.
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A chest, abdominal, and pelvic contrast-enhanced computed tomography (CT) scans showed a 3.8 x 7.2 x 8.7 cm ill-defined mass, involving gastric fundus and extending into gastric cardia and lower gastroesophageal junction (Figures 1(a) and 1(b)).
Positron emission tomography (PET) (a) and transverse-section positron emission tomography-computed tomography (PET-CT) (b) scans: showing hypermetabolic fluorodeoxyglucose- (FDG-) avid mass lesion in gastric fundus and extending into gastric cardia and lower gastroesophageal junction. In addition, it was associated with a few hypermetabolic FDG-avid lesions in the gastrohepatic junction, indicating lymph node metastases. No evidence of distant metastasis was identified.
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Positron emission tomography (PET) (Figure 2(a)) and transverse-section PET-CT (Figure 2(b)) scans showed hypermetabolic fluorodeoxyglucose- (FDG-) avid mass lesion in gastric fundus, extending into gastric cardia and lower gastroesophageal junction.
Desmoplastic small round cell tumor (DSRCT) of the resected gastric tumor mass. (a) Gross examination: cut section of gastric mass revealed a 2.5 x 4.5 x 6.5 cm, irregular, ulcerated, necrotic, and hemorrhagic mass involving the gastric fundus and extending into cardia and lower gastroesophageal junction. (b) Histopathological examination: showing intact epithelial mucosa and presence of sheets of small round blue cells separated by minimal desmoplastic fibrous stroma. (c) Desmin immunostaining: showing positive cytoplasmic staining in the tumor cells (magnification power: x400). (d) AE1/AE3 (cytokeratin) immunostaining: showing focal mild positive staining in the tumor cells (magnification power: x400). (e) WT1 immunostaining: showing dot-like positivity in the tumor cells (magnification power: x400).
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Cut section of gastric mass revealed a 2.5 x 4.5 x 6.5 cm, irregular, ulcerated, necrotic, and hemorrhagic mass involving the gastric fundus, and extending into cardia and lower gastroesophageal junction (Figure 3(a)). Microscopically, histopathological examination of the resected gastric mass revealed intact epithelial mucosa and presence of sheets of small round blue cells separated by minimal desmoplastic stroma (Figure 3(b)). Immunohistochemical stains showed diffuse perinuclear staining pattern with desmin, but characteristic dot positivity was not prominent (Figure 3(c)). There was focal mild positive staining with AE1/AE3 (cytokeratin) (Figure 3(d)) as well as patchy dot positivity with WT1 (Figure 3(e)).