PMC9977106_01
Esophagoduodenoscopy demonstrating a mass in the third portion of the duodenum, observed as an edematous mucosal wall indicated by the arrowheads under natural light (A) and narrow band imaging (B).
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FIG1
While the latter was unremarkable, the former revealed a nodular mass in the third portion of the duodenum, from which a biopsy was obtained (Figure 1).
MRI of the liver with and without contrast demonstrating several variable sized lesions in the liver with a nonspecific appearance, representing either multiple abscesses or necrotic metastases (demarcated by arrows).
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FIG2
An MRI of the abdomen was subsequently performed for better characterization and revealed a partially cystic soft tissue mass in the left mid abdomen measuring 3.6 cm x 4.4 cm x 4.8 cm, along with at least 24 variably sized lesions in the liver with a nonspecific appearance believed to represent either multiple abscesses or necrotic metastases (Figure 2).
The first image (A) is an H&E stain showing spindle cell proliferation. The second image (B) shows diffuse and strong brown CD117 and focally positive CD34 (indicated by arrows) immunohistochemical staining, and negative stains for smooth muscle, actin, and desmin.
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FIG3
Immunohistochemical staining was notable for the presence of CD117, patchy staining for CD34, and negative staining for actin and desmin, which was consistent with GIST (Figure 3).