PMC2765729_01
(a) Abdominal CT showing a huge tumor as a low-density mass occupying much of the left side of the abdominal cavity. (b) Sagittal T2-weighted MR image showing a mosaic-patterned high-intensity mass, with an enclosed low-intensity septum.
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fig1
Esophago-gastro-duodenoscopy (EGD) showed a subepithelial mass on the upper gastric corpus; an abdominal CT showed a huge tumor as a low-density mass occupying most of the left side of the abdominal cavity (Figure 1(a)). Abdominal MRI displayed the tumor as a high-intensity image on the T1 and as a mosaic-patterned high-intensity image on T2 images, showing a septum within it (Figure 1(b)).
A mass was identified as hypoechoic with some partial hyperechoic lesions suggesting hemorrhage within the tumor on EUS. EUS-FNA was performed using the transgastric approach.
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fig2
Results of EUS showed a hypoechoic area with some partial hyperechoic lesions, suggesting hemorrhage within the tumor (Figure 2).
Histopathological examination revealed a few signet-ring-cell-like lipoblasts and several pleomorphic cells manifested in a myxoid background (Giemsa stain, x60).
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Cytopathological examination of the sample obtained by EUS-FNA revealed spindle cells as well as myxoid and round cells (Figure 3).
PMC2765729_02
(a) CT showing a 6 cm diameter low-density tumor within the pelvis. (b) Axial T2-weighted MR image showing a very-high-intensity mass with a low-intensity septum (arrows).
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fig4
Results of CT showed a 6 cm diameter low-density tumor within the pelvis (Figure 4(a)). Abdominal MRI showed a tumor detected as high-intensity on both T1 and T2 images with a low-intensity septum (Figure 4(b)).
EUS showed that the internal echo was homogeneously hyperechoic and the hypoechoic septum (arrows) was also apparent. Subsequently EUS-FNA was performed using a transrectal approach.
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fig5
Subsequent EUS showed that the internal echo was homogeneously hyperechoic and the hypoechoic septum was also apparent (Figure 5).
Histopathological examination revealed lipoblasts of various sizes and spindle cells with slightly atypical nucleus manifested against a myxoid background (Giemsa stain, x60).
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In addition, some spindle cell clusters manifested a myxoid background (Figure 6).