Diagnostic utility of endoscopic ultrasound-guided fine-needle aspiration biopsy for glomus tumor of the stomach

Table 1 Cases of gastric glomus tumor with preoperative fine-needle aspiration biopsy

	Vinette-Leduc et al[19]	Gu et al[16]	Debol et al[15]	Jones et al[20]	Minoda et al[21]	Mohanty et al[22]	Matevossian et al[23]	Akahoshi et al[18]	Our case
Age and sex	72, female	32 , female	62, female	47, female	50, female	51, male	44	N.D.	52, male
Tumor location size (cm)	Antrum	Body (LC)	Antrum	ND	Angle	Antrum	Antrum	Body	Antrum
	2	2.3 × 1.6	2.8 × 2.5 × 1.7	2.5 × 1.5	1.5	2.4 × 2.0	5	1.2	3
Enhanced CT	ND	ND	ND	ND	ND	ND	ND	N.D.	Enhanced in peripheral lesion, not homogeneously.
EUS	ND	Irregular shaped heterogeneous tumor arising from muscularis propria	Hypoechoic mass arise from the muscularis propria	Heterogeneous rounded lesion arising from muscularis propria	Homogeneous, hypoechoic tumor with continuity to the muscle layer	Hypoechoic submucosal lesion	Poorly reflective, non-homogeneous submucosal, solid tumor.	N.D.	Hypoechoic mass primarily connected to muscular layer
Diagnosis by images	ND	GIST	ND	GIST	GIMT including GIST	ND	GIST	N.D.	GIMT including GIST
FNA-procedure	Percutaneous FNA	EUS-FNA	EUS-FNA	EUS-FNA	EUS-FNA (25-gauge needle)	EUS-FNA	EUS-FNA (19-gauge needle)	EUS-FNA (22 or 25-gauge)	EUS-FNA (22-gauge needle)
FNA cytology (HE)	Well-demarcated nests of small, round to polygonal cells.	Small, uniform, round, epithelioid cells with round nuclei and scanty, amphophilic cytoplasm	Well differentiated small blue cell neoplasm like carcinoid tumor.	Epitheloid tumor cells.	Proliferation of oval shaped cells with eosinophilic cytoplasm arrange in nests.	Uniform round cells with ill-defined cytoplasmic borders and scanty amphophillic cytoplasm.	Hemorrhagic biopsy sample without representative cells.	N.D.	proliferation of oval-shaped cell with small nest formation .
FNA cytology (IHC staining)	Not performed.	c-kit, CD34, desmin, chromogranin, synaptophisin,desmin (-), SMA, vimentin (+)	CD34, synaptophisin,chromogranin, s-100,Desmin, CD117 (-), SMA, vimentin (+)	CD34, 56, c-kit, chromogranin (-) synaptophisin (±), SMA (+)	CD34, 56, c-kit, desmin, S-100, chromogranin, synaptophisin (-), SMA, vimentin (+)	CD34, 117, c-kit, desmin, chromogranin, Synaptophisin , Pancytokeratin (-), SMA, vimentin (+)	Not performed	N.D.	CD34, 56, c-kit, desmin,S-100, chromogranin(-), synaptophisin (±), SMA (+)
Preoperative diagnosis	Neuroendocrine tumor	Glomus tumor	Glomus tumor	Glomus tumor	Glomus tumor	Glomus tumor	GIST	Glomus tumor	Glomus tumor
Pathology in resected specimen (HE)	Highly vascular, tumor nests were separated by fascicles of smooth muscle. Uniform, small and round tumor cells.	Non encapsulated, with convoluted boundaries, confined to muscularis propria. Round and uniform tumor cells	Circumscribed, highly vascular, and contained nests of monomorphic, polygonal cells.	Confirmed the preoperative diagnosis of a glomus tumor.	Same as FNA pathology.	The pathological diagnosis was confirmed on resection	ND	N.D.	Oval shaped cells with high N/C ratio proliferated on proper muscle layer performing solid small nests.
IHC staining in resected specimen	Desmin, chromogranin (-), SMA, Vimentin (+)	Similar to those performed FNA	CD34, CD117, chromogranin (-), SMA, Vimentin (+)	ND	Same as FNA staining.	The pathological diagnosis was confirmed on resection	CD117 (-), Vimentin/actin (+)	N.D.	Same as FNA staining

ND: No description; GIMT: Gastrointestinal mesenchymal tumor; HE: Hematoxylin-eosin; IHC: Immunohistochemical; LC: Lesser curvature.