PMC5283957_01
a: Endoscopic findings in 2005 revealed an elevated lesion resembling a submucosal tumor with slight depression on the posterior wall of the middle body. b: Endoscopic findings in 2009 showed no change in the tumor size or shape. c: Endoscopic findings in 2010 showed a marked tumor growth and central depression. d: Endoscopic findings in 2011 showed tumor growth with a reddish appearance and a styloid form of the tumor root and deeper depression at the center.
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She was referred to our hospital in 2011 for a growing gastric tumor work up because her tumor eventually grew to the size of 15 mm, and a depression clearly appeared at the top of tumor (Fig. 1).
a: An endoscopic examination revealed an elevated lesion, similar to a submucosal tumor, with erosion on the posterior wall of the middle body. b: A retroflexion picture of a showed a styloid form of the tumor root. c: An endoscopic examination revealed a distinct elevated lesion with a depressed area on the lesser curvature of the middle body (arrows). d: A retroflecion image of c showed an erythrogenic tumor without ulcerative change (arrows).
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An endoscopic examination revealed two isolated gastric tumors, one was the original tumor, and the other was a superficial tumor with a depressed area (Fig. 2).
Histological findings of the resected specimen revealed diffuse proliferation of the plasmacytoid cells with Dutcher bodies. a: A histological examination of the biopsied samples taken from superficial type plasmacytoma [Hematoxylin and Eosin (H&E) staining, 400x]. b: A histological examination of biopsied samples taken from nodular/SMT type plasmacytoma (H&E staining, 400x). c: Immunohistochemistry of b showing positivity for Kappa chains in tumor cells (immunoperoxidase stain, 400x). d: Immunohistochemistry of b showing positivity for IgA chains in tumor cells (immunoperoxidase stain, 400x). e: A high-power field of a represents Dutcher bodies (arrow) (H&E staining, 400x).
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Immunoperoxidase staining showed monoclonal growth of Kappa chain-positive cells and IgA chain-positive cells (Fig. 3).