PMC7803177_01
CT images showing a gastric mass. A 4.7 cm lobulated submucosal gastric mass at the gastric cardia near the gastroesophageal junction. The mass has an exophytic component abutting the left hemidiaphragm and left liver lobe.
CRIS2020-9037960.001.jpg
PMC7803177_01_CRIS2020-9037960.001.jpg
fig1
Superiorly, the mass had an exophytic component abutting the left hemidiaphragm and near the inferior aspect of the left hepatic lobe (Figure 1).
Upper gastrointestinal endoscopy revealed submucosal mass measuring 4.7 cm, located at the cardia, with deep ulcer.
CRIS2020-9037960.002.jpg
PMC7803177_01_CRIS2020-9037960.002.jpg
fig2
Upper gastrointestinal (GI) endoscopy was done and showed normal esophagus, submucosal mass (5 cm) with deep ulcer at the cardia, and first and second parts of the duodenum were normal (Figure 2).
(a) Low-power magnification featuring bundles of smooth muscle fibers with intervening vascularized myxoid tumor, forming a plexiform pattern (H&E x40). (b) Low-power magnification featuring myxoid vascularized areas alternating with cellular bundles of smooth muscle fibers (H&E x40). (c) Spindle-shaped cells free of atypia or mitotic activity within myxoid stroma (H&E x100).
CRIS2020-9037960.003.jpg
PMC7803177_01_CRIS2020-9037960.003.jpg
fig3
The tumor nodules were seen dissecting their way or surrounded or traversed by bundles of smooth muscle fibers derived from the muscularis propria resulting in a plexiform pattern (Figures 3(a)-3(c)).
(a) Immunohistochemical stain for smooth muscle actin (SMA) featuring positive staining of normal muscle fibers of the stomach, walls of blood vessels, and spindle tumor cells. (b) Immunohistochemical stain for CD117 (C-Kit), a marker for GIST, featuring negative staining of spindle tumor cells.
CRIS2020-9037960.004.jpg
PMC7803177_01_CRIS2020-9037960.004.jpg
fig4
These histological and immunohistochemical findings confirmed this tumor as PF (Figures 4(a) and 4(b)).