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1
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Prasad AS, Shanbhogue KP, Ramani NS, Balasubramanya R, Surabhi VR. Non-gastrointestinal stromal tumor, mesenchymal neoplasms of the gastrointestinal tract: a review of tumor genetics, pathology, and cross-sectional imaging findings. Abdom Radiol (NY) 2024; 49:1716-1733. [PMID: 38691132 DOI: 10.1007/s00261-024-04329-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 04/01/2024] [Accepted: 04/02/2024] [Indexed: 05/03/2024]
Abstract
There is a diverse group of non-gastrointestinal stromal tumor (GIST), mesenchymal neoplasms of the gastrointestinal (GI) tract that demonstrate characteristic pathology and histogenesis as well as variable imaging findings and biological behavior. Recent advancements in tumor genetics have unveiled specific abnormalities associated with certain tumors, influencing their molecular pathogenesis, biology, response to treatment, and prognosis. Notably, giant fibrovascular polyps of the esophagus, identified through MDM2 gene amplifications, are now classified as liposarcomas. Some tumors exhibit distinctive patterns of disease distribution. Glomus tumors and plexiform fibromyxomas exhibit a pronounced affinity for the gastric antrum. In contrast, smooth muscle tumors within the GI tract are predominantly found in the esophagus and colorectum, surpassing the incidence of GISTs in these locations. Surgical resection suffices for symptomatic benign tumors; multimodality treatment may be necessary for frank sarcomas. This article aims to elucidate the cross-sectional imaging findings associated with a wide spectrum of these tumors, providing insights that align with their histopathological features.
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Affiliation(s)
| | | | - Nisha S Ramani
- Department of Pathology, Michael E. DeBakey VA Medical Center, Houston, USA
| | | | - Venkateswar R Surabhi
- Department of Abdominal Imaging, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1473, Houston, TX, 77030, USA.
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2
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Chen LJ, Han YD, Zhang M. CT features of calcified micro-gastric gastrointestinal stromal tumors: a case series. BMC Med Imaging 2023; 23:192. [PMID: 37986048 PMCID: PMC10662392 DOI: 10.1186/s12880-023-01146-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 10/30/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Due to the lack of corresponding clinical symptoms, small calcified gastric gastrointestinal stromal tumors (GISTs) are often overlooked in clinical practice. Therefore, there is an unmet need to define the imaging features of calcified micro-gastric GISTs to facilitate diagnosis. This study retrospectively analyzed the computed tomography (CT) features of pathologically confirmed calcified micro-gastric GISTs. METHODS The medical records (gastroscopy, pre-treatment gastric CT imaging [pre- and post-contrast scans], pathology) of patients with calcified gastric GISTs < 1 cm in diameter confirmed pathologically after endoscopic submucosal dissection, endoscopic submucosal excavation, or endoscopic full-thickness resection were retrospectively reviewed. RESULTS Seven patients had 8 calcified gastric GISTs < 1 cm in diameter. Six patients hadsingle lesions, and 1patients had multiple lesions. Six patients had lesions in the gastric fundus, 1 patient had a lesion in the body of the stomach. Lesions had a mean diameter of 5.2 mm (range, 1.3 mm ~ 7 mm). Unenhanced CT scans showed spots and high-density nodular calcifications in 3 submucosal lesions, 2 lesions in the muscularis propria, and 3 subserosal lesions that protruded outside the stomach. Among the 8 lesions, only two had solid soft tissue components surrounding the calcification, with one of these two showing post contrast enhancement of the solid soft tissue component. CONCLUSIONS Novel CT features of gastric GISTs included: commonly found in the gastric antrum, small size (< 1 cm in diameter), calcification, few solid soft tissue components, and no abnormal enhancement in most cases.
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Affiliation(s)
- Li-Jun Chen
- The Department for Radiology, Gao Xin Hospital Xi'an, Xi'an, Shannxi, 710075, China
- Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiao Tong University, No.277, West Yanta Road, Xi'an, Shaanxi, 710061, P.R. China
| | - Yue-Dong Han
- The Department for Radiology, Gao Xin Hospital Xi'an, Xi'an, Shannxi, 710075, China
| | - Ming Zhang
- Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiao Tong University, No.277, West Yanta Road, Xi'an, Shaanxi, 710061, P.R. China.
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3
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Lee JS, Park SH, Choi SJ. Radiologic Review of Small Bowel Malignancies and Their Mimicking Lesions. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2023; 84:110-126. [PMID: 36818705 PMCID: PMC9935952 DOI: 10.3348/jksr.2021.0168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/22/2021] [Accepted: 04/19/2022] [Indexed: 11/18/2022]
Abstract
Because of their small size, small bowel malignancies are often easily missed when radiologists read CT images, which can lead to errors in the normal small bowel due to their similar enhancement to the small bowel or non-specific enhancement. In addition, small bowel malignancies are sometimes mistaken for masses of other origins, such as the uterus, rectum, or omentum. In this article, we describe various small-bowel malignancies, their mimicking lesions and the typical and atypical features on CT imaging along with their clinical manifestations.
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Affiliation(s)
- Jong Soo Lee
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - So Hyun Park
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
| | - Seung Joon Choi
- Department of Radiology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
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4
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López Grove R, Gentile E, Savluk L, Santino JP, Ulla M. Correlation between pneumo-computed tomography and pathology findings for subepithelial gastric lesions. RADIOLOGIA 2022; 64:237-244. [PMID: 35676055 DOI: 10.1016/j.rxeng.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 02/09/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This article aims to show the usefulness of the pneumo-computed tomography gastric distention technique in the detection and morphological characterization of subepithelial gastric lesions. We correlate the pneumo-computed tomography and pathology findings in lesions studied at our institution and review the relevant literature. CONCLUSION Pneumo-computed tomography, combined with multiplanar reconstructions, three-dimensional reconstructions, and virtual endoscopy, is useful for delineating the morphological details of subepithelial gastric lesions, thanks to the additional gastric distention. This technique better delimits and characterizes the upper and lower margins of the lesions. Pneumo-computed tomography can be considered a useful noninvasive imaging techniques for characterizing these lesions.
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Affiliation(s)
- R López Grove
- Servicio de Diagnóstico por Imágenes, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina.
| | - E Gentile
- Servicio de Diagnóstico por Imágenes, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - L Savluk
- Servicio de Diagnóstico por Imágenes, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - J P Santino
- Servicio de Anatomía Patológica, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
| | - M Ulla
- Servicio de Diagnóstico por Imágenes, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
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5
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López Grove R, Gentile E, Savluk L, Santino J, Ulla M. Correlación anatomopatológica con neumo-tomografía computarizada de lesiones gástricas subepiteliales. RADIOLOGIA 2022. [DOI: 10.1016/j.rx.2022.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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6
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Garmpis N, Damaskos C, Garmpi A, Georgakopoulou VE, Sakellariou S, Liakea A, Schizas D, Diamantis E, Farmaki P, Voutyritsa E, Syllaios A, Patsouras A, Sypsa G, Agorogianni A, Stelianidi A, Antoniou EA, Kontzoglou K, Trakas N, Dimitroulis D. Inflammatory Fibroid Polyp of the Gastrointestinal Tract: A Systematic Review for a Benign Tumor. In Vivo 2021; 35:81-93. [PMID: 33402453 DOI: 10.21873/invivo.12235] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/04/2020] [Accepted: 10/06/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND/AIM Inflammatory fibroid polyp (IFP) is a rare, usually solitary and intraluminal polypoid benign tumor that can affect any part of the gastrointestinal (GI) tract, although in the majority of cases it affects the stomach. This lesion is characterized by proliferation of highly vascular fibrous tissue and infiltration by a variable number of different inflammatory cells. Its etiology is unknown. Our aim was to describe all the reported data concerning IFP. MATERIALS AND METHODS An extensive search of the PubMed Index was performed for publications with titles or abstracts containing the terms: "inflammatory fibroid polyp" with/without "Vanek". Results were filtered for publications in English and concerning only humans. One hundred and twenty-four publications were finally included in this review. RESULTS IFP has a female predominance. It affects patients in their 5th decade of life, although there are cases of patients from 4 to 84 years of age. IFP usually affects the stomach and more specifically the gastric antrum but can be detected throughout the GI tract. A significant number of cases remain asymptomatic but the most frequent presentations of IFP are abdominal pain, acute abdomen and GI bleeding. Most cases are treated by endoscopic resection of the lesion. No recurrence nor IFP-specific complications have been reported. Histopathology of IFP varies. CONCLUSION It is relatively safe to conclude that both the etiology and the timing of diagnosis might change the histopathology, immunohistological staining and tissue structure of IFP. Suggested theories should be taken into consideration with caution as the etiology and pathophysiological mechanisms of IFP are unknown.
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Affiliation(s)
- Nikolaos Garmpis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Christos Damaskos
- Renal Transplantation Unit, Laiko General Hospital, Athens, Greece; .,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasiliki E Georgakopoulou
- Department of Pulmonology, Laiko General Hospital, Athens, Greece.,First Department of Pulmonology, Sismanogleio Hospital, Athens, Greece
| | - Stratigoula Sakellariou
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Aliki Liakea
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Schizas
- First Department of Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelos Diamantis
- Department of Endocrinology and Diabetes Center, G. Gennimatas General Hospital, Athens, Greece
| | - Paraskevi Farmaki
- First Department of Pediatrics, Agia Sofia Children's Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Errika Voutyritsa
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Syllaios
- First Department of Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandros Patsouras
- Second Department of Internal Medicine, Tzanio General Hospital, Piraeus, Greece
| | - Georgia Sypsa
- Department of Pulmonology, Laiko General Hospital, Athens, Greece
| | | | - Athanasia Stelianidi
- First Department of Pediatrics, Agia Sofia Children's Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Efstathios A Antoniou
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Kontzoglou
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Trakas
- Department of Biochemistry, Sismanogleio Hospital, Athens, Greece
| | - Dimitrios Dimitroulis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Bechara R, Hurlbut D, Grin A. Gastric Inflammatory Fibroid Polyp: A Rare Incidental Finding on Endoscopy. J Can Assoc Gastroenterol 2021; 4:149-150. [PMID: 34337313 PMCID: PMC8320293 DOI: 10.1093/jcag/gwaa030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Indexed: 01/19/2023] Open
Affiliation(s)
- Robert Bechara
- Department of Medicine, Division of Gastroenterology, Queens University, Kingston Health Sciences Center, Kingston, Ontario, Canada
| | - David Hurlbut
- Department of Pathology and Molecular Medicine, Queens University, Kingston Health Sciences Center, Kingston, Ontario, Canada
| | - Andrea Grin
- Department of Pathology and Molecular Medicine, Queens University, Kingston Health Sciences Center, Kingston, Ontario, Canada
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8
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Inayat F, Ur Rahman A, Wahab A, Riaz A, Zahid E, Bejarano P, Pimentel R. Gastric Inflammatory Fibroid Polyp: A Rare Cause of Occult Upper Gastrointestinal Bleeding. J Investig Med High Impact Case Rep 2021; 8:2324709620936840. [PMID: 32602395 PMCID: PMC7328486 DOI: 10.1177/2324709620936840] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Inflammatory fibroid polyps (IFPs) are rare mesenchymal lesions that can arise
throughout the gastrointestinal tract. These tumors represent less than 0.1% of
all gastric polypoid lesions and are frequently found incidentally on endoscopic
evaluation. While presenting symptoms depend on the location of the tumor,
gastric polyps commonly present with epigastric pain and early satiety. We
hereby delineate the case of a middle-aged female who presented with chronic
iron deficiency anemia and a positive fecal occult blood test. She underwent an
upper endoscopy, which revealed an actively oozing umbilicated lesion in the
gastric antrum. Endoscopic ultrasound divulged the submucosal origin of the
lesion. It was subsequently excised using endoscopic mucosal resection.
Pathologic examination of the resected specimen confirmed the diagnosis of
gastric IFP. Furthermore, we conducted a systematic literature search of the
MEDLINE database centered on gastric IFPs from January 2000 till March 2020. The
data on patient demographics, clinical features, endoscopic findings, lesion
site and size, and treatment approaches were collected and analyzed. This
article illustrates the overarching need for clinicians to be vigilant of
gastric IFPs presenting with initial clinical symptoms suggestive of occult
upper gastrointestinal bleeding. Prompt diagnosis and management of gastric IFPs
carry paramount importance to combat chronic unexplained iron deficiency anemia
following occult bleeding in such patients. A concoction of endoscopy, biopsy,
and immunohistochemical examination can be employed toward their prompt
detection. Although gastric IFPs have conventionally been treated with surgery,
endoscopic resection is now emerging as a safe and efficient therapeutic
modality.
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Affiliation(s)
| | | | - Ahsan Wahab
- Baptist Medical Center South, Montgomery, AL, USA
| | - Amir Riaz
- Cleveland Clinic Florida, Weston, FL, USA
| | - Effa Zahid
- Services Institute of Medical Sciences, Lahore, Pakistan
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9
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Park JS, Kim JW, Gu MJ. Inflammatory Fibroid Polyp of the Appendix: A Case Report. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2020; 81:203-206. [PMID: 36238124 PMCID: PMC9432099 DOI: 10.3348/jksr.2020.81.1.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 06/13/2019] [Accepted: 06/26/2019] [Indexed: 12/05/2022]
Abstract
소화기계에 발생한 염증성 섬유성 용종은 드물게 보고되는 양성질환으로 소화관 내 어디서든 생길 수 있으며 주로 위와 회장에 많이 생기나 충수에서도 매우 드물게 생길 수 있다(< 1%). 저자들은 충수에서 발견된 염증성 섬유성 용종 1예를 증례 보고하고자 한다.
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Affiliation(s)
- Jong Soo Park
- Department of Radiology, College of Medicine, Yeungnam University, Daegu, Korea
| | - Jae Woon Kim
- Department of Radiology, College of Medicine, Yeungnam University, Daegu, Korea
| | - Mi Jin Gu
- Department of Pathology, College of Medicine, Yeungnam University, Daegu, Korea
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10
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Kim SW, Kim HC, Oh J, Won KY, Park SJ, Yang DM. Tumors of the jejunum and ileum: a pattern-based imaging approach on CT. Abdom Radiol (NY) 2019; 44:2337-2345. [PMID: 30877330 DOI: 10.1007/s00261-019-01978-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Since a broad spectrum of tumors can occur in the small bowels, it is not easy to make a correct differential diagnosis among small bowel tumors on CT findings. Therefore, once a mass is detected on CT, the radiologist needs to analyze the mass based on presenting patterns such as location, multiplicity, morphology, and enhancement patterns. In this article, we will illustrate various kinds of small bowel tumors based on imaging patterns at CT to facilitate making a correct diagnosis.
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Affiliation(s)
- Sang Won Kim
- Department of Radiology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, 149 Sangil-Dong, Gangdong-Gu, Seoul, 134-727, Korea.
| | - Hyun Cheol Kim
- Department of Radiology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, 149 Sangil-Dong, Gangdong-Gu, Seoul, 134-727, Korea
| | - Jiyoung Oh
- Department of Radiology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, 149 Sangil-Dong, Gangdong-Gu, Seoul, 134-727, Korea
| | - Kyu Yeoun Won
- Deparment of Pathology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Seong Jin Park
- Department of Radiology, Kyung Hee University Hospital, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Dal Mo Yang
- Department of Radiology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, 149 Sangil-Dong, Gangdong-Gu, Seoul, 134-727, Korea
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11
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Tanaka T, Akiyoshi H, Mie K, Okamoto M, Yoshida Y, Kurokawa S. Contrast-enhanced computed tomography may be helpful for characterizing and staging canine gastric tumors. Vet Radiol Ultrasound 2018; 60:7-18. [PMID: 30123960 DOI: 10.1111/vru.12677] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 06/04/2018] [Accepted: 06/04/2018] [Indexed: 02/06/2023] Open
Abstract
In humans, computed tomography (CT) is a widely performed technique for the diagnosis and staging of gastric tumors. The purpose of this retrospective case series study was to describe CT findings in a group of dogs with confirmed gastric tumors. For each included dog, the following CT parameters were recorded: gastric tumor location, tumor shape, gastric involvement pattern, tumor enhancement pattern in early and late phases, presence and location of lymphadenopathy, gastric tumor attenuation values, attenuation values of enlarged lymph nodes, maximum short-axis diameter (mm) of enlarged lymph node, maximum long-axis diameter (mm) of enlarged lymph node, and short-axis diameter to long-axis diameter ratio (short axis/long axis). A total of 16 dogs met inclusion criteria and had the following final diagnoses: five lymphoma, six adenocarcinoma, three inflammatory polyps, and two leiomyoma. In the early- and delayed-phase postcontrast images, the mean CT attenuation value for lymphoma was lower than that of other gastric tumors. Lymphadenopathy was widespread in lymphomas and regional in adenocarcinomas. Lymphadenopathy was not detected in leiomyomas. Lymph node measurements in lymphoma were larger than lymph node measurements in adenocarcinoma. Although there were overlapping findings for the different types of gastric tumors, contrast-enhanced CT provided helpful information for characterizing gastric tumors based on the following criteria: early and late enhancement patterns, the site of origin of the mass lesion, and extent of local invasion and distant metastases. Lymphoma should be considered for canine gastric tumors with low mean attenuation values during early- and delayed-phase postcontrast images, and widespread, bulky, and rounded lymphadenopathy.
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Affiliation(s)
- Toshiyuki Tanaka
- Laboratory of Veterinary Surgery, Department of Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano-shi, Osaka, 598-8531, Japan.,Kinki Animal Medical Training Institute & Veterinary Clinic, Higashiosaka, Osaka, 578-0984, Japan
| | - Hideo Akiyoshi
- Laboratory of Veterinary Surgery, Department of Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano-shi, Osaka, 598-8531, Japan
| | - Keiichiro Mie
- Laboratory of Veterinary Surgery, Department of Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano-shi, Osaka, 598-8531, Japan
| | - Mari Okamoto
- Laboratory of Veterinary Surgery, Department of Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano-shi, Osaka, 598-8531, Japan
| | - Yuuki Yoshida
- Laboratory of Veterinary Surgery, Department of Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano-shi, Osaka, 598-8531, Japan
| | - Shohei Kurokawa
- Laboratory of Veterinary Surgery, Department of Graduate School of Life and Environmental Sciences, Osaka Prefecture University, Izumisano-shi, Osaka, 598-8531, Japan
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12
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Rohit M, Bhatt A, Cruise M, Wearsch PA, Goldblum JR, Sturgis CD. Endoscopic ultrasound FNA: An illustrated review of spindle cell neoplasms of the upper gastrointestinal tract including a novel case of gastric plexiform fibromyxoma. Diagn Cytopathol 2018; 46:730-738. [PMID: 30043412 DOI: 10.1002/dc.24040] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 06/27/2018] [Accepted: 07/05/2018] [Indexed: 02/06/2023]
Abstract
Plexiform fibromyxoma (PF) is a recently-described and rare mesenchymal neoplasm of the gastric wall. A few small case series reports of this spindle cell entity exist in the surgical pathology literature, but to our knowledge no prior endoscopic ultrasound guided fine needle aspiration cytology examples have been reported. In clinical practice, mural gastrointestinal (GI) lesions are often initially evaluated by endoscopic ultrasound guided (EUS) fine needle aspiration (FNA). In addition, newer EUS fine needle biopsy techniques also allow for reliable retrieval of core tissue samples with intact cellular architecture, making EUS histopathologic analyses possible. We report a combined EUS FNA and core biopsy case of PF and correlate the findings with imaging results. The cytomorphology of PF is described and illustrated, and important entities in the differential diagnosis of upper GI spindle cell lesions (including GI stromal tumor, leiomyoma, schwannoma, carcinoid tumor, desmoid-type fibromatosis, and inflammatory fibroid polyp) are reviewed. Illustrated examples of relevant cytomorphologic, cell block histomorphologic and immunohistochemical characteristics are emphasized.
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Affiliation(s)
- Maitreyi Rohit
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio
| | - Amit Bhatt
- Department of Gastrointestinal Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Michael Cruise
- Department of Pathology, Cleveland Clinic, Cleveland, Ohio
| | - Pamela A Wearsch
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio
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13
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Small bowel intussusception due to inflammatory fibroid polyp: A case report. Radiol Case Rep 2018; 13:801-804. [PMID: 29988929 PMCID: PMC6034136 DOI: 10.1016/j.radcr.2018.05.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 05/10/2018] [Accepted: 05/13/2018] [Indexed: 02/07/2023] Open
Abstract
Inflammatory fibroid polyp (IFP), or Vanek's tumor, is a rare benign lesion of the gastrointestinal tract. According to the location and the size of the lesion, patients present with different clinical manifestations. Our case describes a patient who presented with a picture of a small bowel obstruction. Computed tomography revealed ileoileal intussusception without a clear lead point. The patient underwent resection of the intussuscepted small bowel with primary anastomosis. A polypoid mass was identified as the pathologic lead point. Histopathologic analysis revealed an inflammatory fibroid polyp.
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14
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Shim EJ, Ahn SE, Lee DH, Park SJ, Kim YW. Dynamic enhanced computed tomography imaging findings of an inflammatory fibroid polyp with massive fibrosis in the stomach. World J Gastroenterol 2017; 23:2090-2094. [PMID: 28373777 PMCID: PMC5360652 DOI: 10.3748/wjg.v23.i11.2090] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 12/01/2016] [Accepted: 01/11/2017] [Indexed: 02/06/2023] Open
Abstract
Inflammatory fibroid polyp (IFP) is a rare benign lesion of the gastrointestinal tract. We report a case of computed tomography (CT) imaging finding of a gastric IFP with massive fibrosis. CT scans showed thickening of submucosal layer with overlying mucosal hyperenhancement in the gastric antrum. The submucosal layer showed increased enhancement on delayed phase imaging. An antrectomy with gastroduodenostomy was performed because gastric cancer was suspected, particularly signet ring cell carcinoma. The histopathological diagnosis was an IFP with massive fibrosis. The authors suggest that when the submucosal layer of the gastric wall is markedly thickened with delayed enhancement and preservation of the mucosal layer, an IFP with massive fibrosis should be considered in the differential diagnosis.
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