PMC6138857_01
Abdominal tomography examination showing the well-defined gastric antral lesion.
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Abdominal CT showed an 18 mm well defined lesion at the gastric antrum with arterial enhancement, suggestive of GIST (Fig. 1).
Endoscopic ultrasound examination of the mass showing the heterogeneous oval shaped intra-parietal lesion, measuring 17.7 x 16 mm on large diameters.
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EUS revealed an intraparietal lesion developing from the muscularis propria, measuring 17.7 x 16 mm on largest diameters, oval, with sharp margins and regular edges, mainly hypoechoic, with heterogeneous content (Fig. 2).
Immuno-histochemical staining for IgG4 revealing the presence of numerous positive plasmacytes.
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Numerous inflammatory cells stained positive for anti CD138 along with anti-IgG4 with a ratio of IgG4/IgG total >40%, and a number of IgG4 positive cells >50/HPF, which proved the tumor to be an IgG4-related inflammatory pseudo-tumor (Fig. 3).