PMC5356208_01
Chest CT with contrast (axial view) showing a hiatal hernia with a rounded mass projecting into the lumen with multiple calcifications.
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F1
A computed tomography (CT) scan of the chest with contrast showed a hiatal hernia with a rounded mass containing multiple calcifications and projecting into the lumen (Figure 1).
EGD revealing a subtle submucosal bulging in the hiatal hernia.
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F2
Esophagogastroduodenoscopy (EGD) showed a subtle submucosal bulging within a hiatal hernia sac, and endoscopic ultrasound (EUS) revealed a densely calcified hypoechoic mass that appeared to arise from muscularis propria (Figure 2).
Hematoxylin and eosin stain (200x) highlighting fascicles of neoplastic cells with small nuclei and abundant eosinophilic cytoplasm.
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F3
On pathological exam, the mass was consistent with leiomyoma with degenerative changes (Figure 3).
Smooth muscle actin immunohistochemistry (200x) showing diffuse cytoplasmic reactivity.
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F4
Smooth muscle actin immunohistochemistry showed diffuse cytoplasmic reactivity (Figure 4).