PMC6831823_01
Computed tomography scan. Computed tomography scans showed an enlarged retroperitoneal lymph node of the posterior inferior vena cava (A) and rapidly enlarged lymph node after chemotherapy (B).
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About 29 months after gastrectomy, CT imaging was performed and revealed a solitary localized mass measuring 43 mm in diameter among the retroperitoneal lymph nodes of the posterior inferior vena cava (IVC) (Fig. 1A). However, a follow-up CT scan indicated that the tumor rapidly enlarged (59 mm); no new lesions were observed (Fig. 1B).
Macroscopic finding. Grossly, the tumor was hard and fibrotic, measuring 66 x 58 x 50 mm. The cut surfaces were multinodular, diffusely edematous, and myxoid with focal petechial hemorrhagic necrosis (approximately 15%) and fish-flesh appearance.
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The cut surfaces were multinodular, diffusely edematous, and myxoid with focal petechial hemorrhagic necrosis (approximately 15%) and had a fish-flesh appearance (Fig. 2).
Histological examination of biopsy. (A) pleomorphism with bizarre multinucleated tumor cells and high frequency mitosis (hematoxylin and eosin, x100). (B) Tumor cells showed strong reactivity for desmin (desmin, x200).
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The pathological examination showed pleomorphism with bizarre multinucleated tumor cells and an average of 19 mitoses per 10 high-power fields in the tumors (Fig. 3A). The tumor was immunohistochemically positive for smooth muscle actin (SMA), desmin, and H-caldesmon and negative for c-KIT, CD34, and S-100 (Fig. 3B).