PMC3763584_01
Capsule endoscopic finding: a tumor arising from small intestine with intraluminal growth with ulcerated surface.
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On the second day of admission, an endoscopic capsule study was performed which showed an ulcerated tumor in the small bowel with intraluminal growth with ulcerated surface (Figure 1), which was likely the source of the GIb.
Intraoperative finding: a tumor arising from the ileum with extraluminal growth.
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On the third day of admission, an exploratory laparotomy was performed before the capsule passed out of the rectum, which revealed an irregular, firm mass, in total 4.5 x 3.2 x 2.5 cm, in midileum (Figure 2) with a 2 x 2 cm mass protruding from the antimesenteric wall.
Microscopic finding: histological examination showing bundles of spindle cells with elongated nuclei and significant mitotic figures (H and E stain; 100x).
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Histology revealed a high-grade ulcerated GIST with classic spinal cells, clear resection margins, and no lymph node invasion (Figure 3).
Microscopic finding: immunohistochemistry exhibiting a strong positive for CD117 (CD117 stain; 200x).
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Immunohistochemistry was positive for c-kit (CD117) and CD34 immunomarkers (Figure 4).