PMC3268143_01
Endoscopic examination reveals a 4 cm sized irregularly margined mass with intact mucosa (margin) and shallow ulcer (central) in descending colon.
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F1
Colonoscopy demonstrated a 4.0 cm sized-mass with shallow ulceration in the central area and irregular margin accompanied by intact mucosa (Fig. 1).
Trans-axial view (A) and coronal view (B) show a 4.0 cm sized homogeneous enhancing intra-luminal mass (arrow) in descending colon.
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F2
On contrast enhanced view, the mass had enhanced homogeneously in delayed phase (Fig. 2A, B).
Gross examination reveals a 3.9 x 3.8 cm sized, fungating, white to yellow colored and hard mass in descending colon. Mass involves muscularis propria.
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F3
The 3.9 x 3.8 cm sized mass grossly presented a fungating surface, white to yellow color and invaded muscularis propria (Fig. 3).
Tumor is composed of cytologically bland spinle cells arranged in hyaline stroma with scattered inflammatory cells. Inflammatory cells are composed of lymphocytes, histiocytes and plasma cells (A, H&E, x40; B, H&E, x400).
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F4
The specimens did not have celluar atypia or hyperchromatism in the cells (Fig. 4A, B).
Tumor cells stain strongly for vimentin and variably with myoid markers including smooth muscle actin, muscle-specific actin and desmin (A, vimentin, x200; B, actin, x200).
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F5
Immunohistochemically, tumor cells were positive for smooth muscle actin, and vimentin, and negative for desmin, CD117 (c-kit), anaplastic lymphoma kinase (ALK)-1 (Fig. 5A, B).