PMC4727058_01
Enhanced computed tomography scan of an 81-year-old woman showing increased duodenal wall thickness (blue arrows).
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An enhanced computed tomography scan revealed a duodenal tumor associated with increased wall thickness (Fig. 1). A positron emission tomography scan also indicated an abnormal uptake of tracer in the duodenum (Fig. 2).
Positron emission tomography scan of the duodenum showing the abnormal uptake of tracer (red arrows).
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An enhanced computed tomography scan revealed a duodenal tumor associated with increased wall thickness (Fig. 1). A positron emission tomography scan also indicated an abnormal uptake of tracer in the duodenum (Fig. 2).
Endoscopic evaluation revealing a submucosal tumor, ~25 mm in diameter, located in the superior duodenal angle.
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The endoscopic examination showed the presence of an SMT, ~25 mm in diameter, located in the superior duodenal angle (Fig. 3).
Endoscopic ultrasound showing the submucosal tumor-like mass located in the fourth layer (muscularis propria) of the duodenum.
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EUS revealed that the lesion originated from the fourth layer (muscularis propria) of the duodenum (Fig. 4).
Endoscopic view showing the 10-mm mucosal incision, exposing the white-colored tumor at the apex of the submucosal tumor.
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A 10-cm mucosal incision exposed the surface of the SMT apex (Fig. 5), and tissue samples were successfully obtained, followed by closure of the mucosal incision using hemoclips (Fig. 6).
Immunohistochemistry of duodenal submucosal tumor-like mass obtained by mucosal incision-assisted biopsy. Scale bar, 100 microm. CD, cluster of differentiation; H.E., hematoxylin and eosin.
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The pathological examination of the biopsy samples revealed the presence of a diffuse proliferation of atypical lymphocytes, and the expression of cluster of differentiation (CD)20 and CD79a, but no expression of CD3 in the tumor specimens (Fig. 7).