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1
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Tang B, Liu X, Zhang W. CT features of gastric calcifying fibrous tumors: differentiation from gastrointestinal stromal tumors. Abdom Radiol (NY) 2025; 50:1498-1504. [PMID: 39320495 DOI: 10.1007/s00261-024-04600-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2024] [Revised: 09/11/2024] [Accepted: 09/16/2024] [Indexed: 09/26/2024]
Affiliation(s)
- Bo Tang
- Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
| | - Xisheng Liu
- The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Weidong Zhang
- Nanjing First Hospital, Nanjing Medical University, Nanjing, China
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2
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Zhong Z, Li Z, Xing Y, Guo S. Case report: A large gastric calcifying fibrous tumor treated with endoscopic submucosal excavation. Front Oncol 2024; 14:1385695. [PMID: 39188678 PMCID: PMC11345178 DOI: 10.3389/fonc.2024.1385695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 07/29/2024] [Indexed: 08/28/2024] Open
Abstract
Gastric calcifying fibrous tumor (CFT) is a rare benign mesenchymal tumor. Several previous studies have reported surgical resection for gastric CFT larger than 20mm for the difficulty in preoperative diagnosis. Here, we report a rare case of large gastric CFT treated with endoscopic submucosal excavation (ESE). A 70-year-old woman presented with recurrent epigastric pain and underwent endoscopy, which revealed a 35mm-sized submucosal tumor in the gastric body. ESE was performed after imaging examination and endoscopic ultrasonography. En bloc resection was achieved, but due to the specimen's substantial size and difficulty in mincing, it posed challenges for removal through the mouth. Finally, the specimen was temporarily placed in the stomach and was completely removed two days later. The diagnosis was confirmed based on pathological and immunohistochemical findings. There was no recurrence during the patient's 11-month follow-up. We provided a case report related to the diagnosis and endoscopic treatment for large gastric CFT. In addition, our experience of temporarily leaving a large postoperative specimen, considered a benign lesion, in the stomach for later removal was successful but requires appropriate timing to avoid blockage of the gastrointestinal tract.
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Affiliation(s)
- Ziyou Zhong
- The Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
- Department of Gastroenterology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, Guangdong, China
| | - Zhenguo Li
- Department of Pathology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, Guangdong, China
| | - Yufeng Xing
- The Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
- Department of Liver Diseases, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, Guangdong, China
| | - Shaoju Guo
- The Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China
- Department of Gastroenterology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, Guangdong, China
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3
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Miyagawa K, Ikeshita C, Yamajo J, Mochizuki S, Fuji N, Takamatsu T. A Case of Primary Calcified Fibrous Tumor of the Gastric Wall Treated with Laparoscopic Surgery. THE JAPANESE JOURNAL OF GASTROENTEROLOGICAL SURGERY 2023; 56:427-435. [DOI: 10.5833/jjgs.2022.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
Affiliation(s)
| | | | | | | | | | - Tetsuro Takamatsu
- Department of Medical Photonics, Kyoto Prefectural University of Medicine
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4
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Wang J, Ao W, Mao G, Jia Y, Xie Z, Gu C, Yang G. Gastric calcifying fibrous tumors: Computed tomography findings and clinical manifestations. Medicine (Baltimore) 2021; 100:e23334. [PMID: 33592822 PMCID: PMC7870226 DOI: 10.1097/md.0000000000023334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 10/19/2020] [Indexed: 01/05/2023] Open
Abstract
To retrospectively analyze the computed tomography (CT) findings and clinical manifestations of gastric calcifying fibrous tumor (CFTs).The features of 7 cases with pathologically proven gastric CFTs who had undergone CT were assessed, including tumor location, contour, growth, degree of enhancement, calcification and clinical data. In addition, the size and CT value of each lesion were measured. The mean values of these CT findings and clinical data were statistically analyzed only for continuous variables.Four patients were female and three were male (mean age: 33.3 years; range: 22 ∼ 47 years). Nonspecific clinical symptoms: abdominal pain and discomfort were observed in four cases and the CFTs were incidentally detected in the other three cases. Regarding tumor markers, lower ferritin levels were observed in three female patients. All of the gastric CFTs were solitary and mainly located inside the body; they were in round or oval shape and exhibited endophytic growth. Gastric CFTs are usually small sized and could contain confluent and coarse calcifications; cyst, necrosis, ulcer, bleeding and surrounding lymphadenopathy were not found in any of the cases. Unenhanced CT values of gastric CFTs were higher than those of same-transect soft tissue. Mild-to-moderate enhancement in the arterial phase and progressive enhancement in the portal venous phase were mainly noted.A gastric mass with a high unenhanced CT attenuation value, confluent and coarse calcifications and mild-to-moderate enhancement could prompt a diagnosis of gastric CFT. In addition, (1) being young- or middle-aged, (2) having relatively low ferritin levels, and (3) tumor located in the gastric body have critical reference value for diagnosis of gastric CFT.
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Affiliation(s)
- Jian Wang
- Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou
| | - Weiqun Ao
- Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou
| | - Guoqun Mao
- Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou
| | - Yuzhu Jia
- Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou
| | | | - Congyou Gu
- Department of Pathology, First affiliated Hospital of Bengbu Medical College, Bengbu, Anhui Province, China
| | - Guangzhao Yang
- Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou
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5
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Tsai MK, Chen HY, Chuang ML, Chen CW, Jong GP. Gastric Calcifying Fibrous Tumor: An Easy Misdiagnosis as Gastrointestinal Stromal Tumor-A Systemic Review. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E541. [PMID: 33066662 PMCID: PMC7602413 DOI: 10.3390/medicina56100541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/09/2020] [Accepted: 10/13/2020] [Indexed: 01/31/2023]
Abstract
Background and Objectives: Calcifying fibrous tumor (CFT) in the stomach is extremely rare and is easily misdiagnosed as a gastrointestinal stromal tumor (GIST). This study aims to determine the best method to differentiate between gastric CFT and GIST after a systemic review and meta-analysis. Materials and Methods: A systematic search of articles using electronic databases (MEDLINE, EMBASE, and LILACS) was conducted and resulted in 162 articles with 272 CFT cases published from January 1988 to September 2019. Results: Of these cases, 272 patients, 60 patients with gastric CFT (32 men and 28 women, mean age 49.2 years) were analyzed. The mean tumor size was 2.4 cm in patients with gastric CFT. Both endoscopic ultrasound (EUS) and computed tomography (CT) findings revealed well-defined (100% vs. 77.8%), heterogeneous (100% vs. 77.8%), iso-hypoechoic (71.4% vs. 33.3%), and calcified (85.7% vs. 77.8%) lesions, respectively. The majority of patients (53.3%) were symptomatic, with the most common symptom being abdominal discomfort (55.6%). None of the patients with gastric CFT showed recurrence after treatment, and most patients received nonendoscopic treatment (56%, n = 28/50). Both age and tumor size were statistically significant in patients with gastric CFT than GIST (49.2 vs. 65.0 years and 2.4 vs. 6.0 cm; both p < 0.001). The ratio of children among patients with CFT (5%) and GIST (0.05%) was also significantly different (p = 0.037). The calcification rates of gastric CFT had significantly higher calcification rates than GIST on images of EUS and CT (85.7% vs. 3.6% and 77.8% vs. 3.6%; both p < 0.001). Conclusions: Compared with patients with GIST, patients with gastric CFT were younger, had smaller tumor size, and were symptomatic. Furthermore, gastric CFT was well-defined, heterogeneous in the third layer, and had high calcification rates on the images.
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Affiliation(s)
- Meng-Ko Tsai
- Division of Rheumatology, Department of Internal Medicine, Taichung Armed Forces General Hospital, Taichung 41152, Taiwan;
- Division of Rheumatology, Department of Internal Medicine, National Defense Medical Center, Taipei 11490, Taiwan
| | - Hung-Yi Chen
- Department of Pharmacy, China Medical University, Taichung 40402, Taiwan;
- Department of Pharmacy, China Medical University Beigang Hospital, Yunlin County 65152, Taiwan
| | - Ming-Lung Chuang
- Division of Pulmonary Medicine, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung 40201, Taiwan;
- School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
| | - Chun-Wen Chen
- Department of Radiology, Taichung Armed Forces General Hospital, Taichung 41168, Taiwan;
| | - Gwo-Ping Jong
- Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
- Department of Internal Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
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6
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Hamura R, Koyama T, Kawamura M, Kawamura T, Nakamura M, Yanaga K. Gastric calcifying fibrous tumor suspected to be complicated with immunoglobulin G4-related disease treated by laparoscopy and endoscopy cooperative surgery: a case report. Surg Case Rep 2019; 5:150. [PMID: 31641880 PMCID: PMC6805838 DOI: 10.1186/s40792-019-0714-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 09/27/2019] [Indexed: 02/07/2023] Open
Abstract
Background Calcifying fibrous tumor (CFT) is a rare benign soft tissue lesion. Case presentation A 30-year-old woman was admitted to our hospital with complaints of epigastralgia. A 15-mm submucosal tumor was identified in the greater curvature of the superior body of the stomach by upper gastrointestinal endoscopy. Endoscopic ultrasonography revealed a hypoechoic lesion with an acoustic shadow consistent with calcification. Computed tomography showed a gastric tumor with calcification. A gastrointestinal stromal tumor was diagnosed, and gastric wedge resection was performed by laparoscopy and endoscopy cooperative surgery. On pathological examination, the tumor was identified to be a CFT. Postoperative serum IgG4 levels were 26.0 mg/dl, which supported the diagnosis of probable immunoglobulin G (IgG) 4-related disease, according to the comprehensive diagnostic criteria of IgG4-related disease. The patient was discharged on postoperative day 7 and remains well with no evidence of tumor recurrence for 2 years after resection. Conclusion We herein reported a patient with a gastric CFT suspected to be complicated with immunoglobulin G4-related disease that was successfully treated by laparoscopy and endoscopy cooperative surgery.
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Affiliation(s)
- Ryoga Hamura
- Department of Surgery, Kawamura Hospital, Shizuoka, Japan. .,Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
| | - Tomoki Koyama
- Department of Surgery, Kawamura Hospital, Shizuoka, Japan.,Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Masahiko Kawamura
- Department of Surgery, Kawamura Hospital, Shizuoka, Japan.,Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | | | - Mayo Nakamura
- Department of Pathology, The Jikei University School of Medicine, Tokyo, Japan
| | - Katsuhiko Yanaga
- Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
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Kwan BS, Cho DH. Calcifying fibrous tumor originating from the gastrohepatic ligament that mimicked a gastric submucosal tumor: A case report. World J Clin Cases 2019; 7:2802-2807. [PMID: 31616695 PMCID: PMC6789383 DOI: 10.12998/wjcc.v7.i18.2802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 08/04/2019] [Accepted: 08/20/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Calcifying fibrous tumor (CFT) is a rare, benign soft tissue tumor usually occurring in children or young adults. Gastrohepatic ligament CFT with adhesion to the stomach is very rare. We present a case here.
CASE SUMMARY A 25-year-old woman visited our hospital with abdominal pain. Computed tomography and endoscopy were performed, and a gastric submucosal tumor (SMT) with a size of 6.7 cm × 2.7 cm was detected, so endoscopic ultrasonography-guided fine needle biopsy was performed. The tumor was not diagnosed histologically, so surgical resection was planned and performed. The histopathologically confirmed mass size was 6.5 cm × 4.0 cm × 1.0 cm, and a calcified fibrous tumor that originated at the gastrohepatic ligament and adhered to the lesser curvature of the gastric antrum was identified.
CONCLUSION Gastrohepatic ligament CFT is a very rare benign tumor. Since this disease may be confused with gastric SMT, the possibility of CFT should be kept in mind during clinical assessment of this disease.
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Affiliation(s)
- Byung Soo Kwan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon 51353, South Korea
| | - Dae Hyeon Cho
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon 51353, South Korea
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8
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Tian S, Zeng Z, Peng X, Dong W. Gastric calcifying fibrous tumor: A clinicopathological study of nine cases. Exp Ther Med 2018; 16:5137-5143. [PMID: 30546412 PMCID: PMC6256920 DOI: 10.3892/etm.2018.6892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 09/06/2018] [Indexed: 12/17/2022] Open
Abstract
The aim of the present study was to analyze the clinicopathological characteristics presented in 9 cases of gastric calcifying fibrous tumor (CFT), and investigate the expressions and clinical implications of G protein-coupled estrogen receptor (GPER), estrogen receptor (ER) and vimentin in gastric CFTs. The clinical and pathological information of 9 patients with CFTs was investigated retrospectively. Subsequently, the expression of GPER, ER and vimentin were examined using immunohistochemistry, and a literature search for gastric CFT was conducted. The 9 patients were 40–71 years old with a mean age of 52.22 years, including 6 female and 3 male patients. Pathological features included dense hyalinized collagen fibers with a psammomatous body or dystrophic calcification, and the infiltration of scattered lymphocytes and plasma cells. Immunohistochemically, all cases expressed vimentin and GPER, whereas ER expression was negative. Using a database research, 25 studies regarding gastric CFT were identified, including 48 cases with a sex ratio (female:male) of 1.4:1. In addition, the number of female patients was twice the number of male patients in patients <50 years old, whereas the number was almost equal between women and men ≥50 years of age. Gastric CFT is a benign lesion with a good prognosis and a predilection for female patients, particularly premenopausal women. Estrogen may serve a role in this female predominance, and this may be mediated by GPER rather than ER.
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Affiliation(s)
- Shan Tian
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Zhi Zeng
- Department of Pathology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Xiulan Peng
- Department of Oncology, The Fifth Hospital of Wuhan, Wuhan, Hubei 430050, P.R. China
| | - Weiguo Dong
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
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9
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Zhang X, Liu K, Li J. CT Features of Calcifying Fibrous Tumor of the Stomach. J Gastrointest Surg 2018; 22:1455-1456. [PMID: 29340923 DOI: 10.1007/s11605-018-3679-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 01/03/2018] [Indexed: 01/31/2023]
Affiliation(s)
- Xueyan Zhang
- School of Nursing, Binzhou Medical Universtiy, Yantai, Shandong, 264003, China
| | - Kuikui Liu
- School of Nursing, Binzhou Medical Universtiy, Yantai, Shandong, 264003, China
| | - Jun Li
- Department of Radiology, Yantai Affiliated Hospital of Binzhou Medical Universtiy, No. 717, Jinbu Street, Yantai, Shandong, 264100, China.
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10
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Chorti A, Papavramidis TS, Michalopoulos A. Calcifying Fibrous Tumor: Review of 157 Patients Reported in International Literature. Medicine (Baltimore) 2016; 95:e3690. [PMID: 27196478 PMCID: PMC4902420 DOI: 10.1097/md.0000000000003690] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Calcifying fibrous tumor (CFT) is a benign lesion characterized by its specific histological findings and is found as solitary or multiple lesions in several locations of the human body. The aim of the present systematic review is to give a detailed account of all reported cases of CFT in the literature and to analyze the available data, to completely characterize the entity from epidemiological, medical, and surgical aspects.A bibliographic research was performed from 1988 until 2015. A database with the patients' characteristics was made, including sex, age, location of the tumor, symptoms, symptoms duration, size of the tumor, diagnostic methods, treatment, metastasis, and follow-up.A total of 104 articles were identified, reporting 157 cases of CFT. Mean age of patients was 33.58 years and the ratio between men and women was 1:1.27. The most common locations of CFT were stomach (18%), small intestine (8.7%), pleura (9.9%), mesentery (5%), and peritoneum (6.8%). Mean diameter of the tumor was estimated 4.6 cm. The correlations proceeded showed that as age increases, size decreases (P = 0.001) and that the tumor is larger in females (P = 0.027). Kruskal-Wallis test showed that the larger tumors appear in the neck and adrenal gland (P = 0.001). The percentage of asymptomatic patients was 30.57%. Computed tomography and biopsy were the most common tests for the diagnosis of CFT. Open surgical procedure was performed in the majority of cases. The median hospitalization was 6.06 days and the mean follow-up period was 29.97 months. Recurrences were mentioned in 10 of 96 patients with available data. No deaths owing to CFT were mentioned in the literature.CFT should be included in the differential diagnosis of enlarging mass revealed by clinical or imaging examination either incidentally or after specific acute or chronic symptomatology.
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Affiliation(s)
- Angeliki Chorti
- From the 1st Propedeutic Department of Surgery, Aristotle University of Thessaloniki, AHEPA University Hospital, Thessaloniki, Greece
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Abstract
Calcifying fibrous tumor is a benign mass lesion classically described as a soft tissue tumor. However, a thorough review of the literature reveals that it can occur virtually anywhere, including the tubular gastrointestinal (GI) tract. Its clinical manifestations are variable in the GI tract, and its imaging findings are nonspecific. However, it has unique histologic and immunophenotypical features that must be recognized by GI pathologists to differentiate it from an assortment of other rare mesenchymal lesions of the abdomen and GI tract. Calcifying fibrous tumor is composed of a paucicellular collagen matrix, interspersed calcified bodies, and a sparse inflammatory infiltrate. Although calcifying fibrous tumor is benign, pathologists must be aware that it may occur in the GI tract to differentiate it from other potentially more aggressive, rare mesenchymal lesions.
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Affiliation(s)
| | - Deepti Dhall
- From the Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California
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12
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George SA, Abdeen S. Gastric Calcifying Fibrous Tumor Resembling Gastrointestinal Stromal Tumor: A Case Report. IRANIAN JOURNAL OF PATHOLOGY 2015; 10:306-309. [PMID: 26351502 PMCID: PMC4539737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Accepted: 08/17/2014] [Indexed: 06/05/2023]
Abstract
Calcifying fibrous tumor (CFT) is a rare mesenchymal tumor, affecting children and young adults with a predilection for the soft tissue and the abdominal cavity. CFT of the tubular gastrointestinal tract is very rare with less than 20 cases of gastric CFTs reported in English literature. This benign hypocellular fibrosclerotic calcifying lesion can resemble other spindle cell tumors particularly sclerosing gastrointestinal stromal tumor of the stomach. Differentiating between these lesions is particularly important for prognostic and therapeutic purposes. Herein a case of gastric calcifying fibrous tumor incidentally detected during bariatric surgery in a 27-year-old woman is described, with a discussion on its clinicopathological features and differential diagnoses.
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13
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Zhang H, Jin Z, Ding S. Gastric calcifying fibrous tumor: A case of suspected immunoglobulin G4-related gastric disease. Saudi J Gastroenterol 2015; 21:423-6. [PMID: 26655140 PMCID: PMC4707813 DOI: 10.4103/1319-3767.170950] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Gastrointestinal lesions resulting from immunoglobulin G4-related disease are classified into two types: One is a gastrointestinal lesion showing marked thickening of the wall, and the other is an IgG4-related pseudotumor. We report the case of a woman with gastric calcifying fibrous tumor undergoing endoscopic resection that contained 62 IgG4+ plasma cells per high-power field and an IgG4-to-IgG ratio of 41% in lesional plasma cells, which shared clinical and histopathological features associated with gastric IgG4-related pseudotumor. So, we postulate that calcifying fibrous tumor as part of the spectrum of IgG4-related disease might be the unifying concept with IgG4-related pseudotumor. Meanwhile, the patient had coexistent autoimmune diseases, including autoimmune atrophic gastritis, Hashimoto's thyroiditis, and possible primary biliary cirrhosis. The clinical follow-up evaluation was uneventful.
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Affiliation(s)
- Hejun Zhang
- Department of Gastroenterology, Peking University Third Hospital, Beijing, China
| | - Zhu Jin
- Department of Gastroenterology, Peking University Third Hospital, Beijing, China
| | - Shigang Ding
- Department of Gastroenterology, Peking University Third Hospital, Beijing, China,Address for correspondence: Dr. Shigang Ding, No. 49 Road Huayuan North, Haidian District, Beijing - 100191, PR China. E-mail:
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14
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Larson BK, Balzer B, Goldwasser J, Dhall D. Calcifying fibrous tumor: an unrecognized IgG4--related disease? APMIS 2014; 123:72-6. [PMID: 25244325 DOI: 10.1111/apm.12302] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 06/15/2014] [Indexed: 12/17/2022]
Abstract
Calcifying fibrous tumor is a rare benign mass lesion characterized by bland spindle cells embedded in abundant collagenous matrix, interspersed dystrophic or psammomatous calcifications, and lymphoplasmacytic infiltrate. It shares several clinical and morphologic features with IgG4-related disease, a newly recognized fibroinflammatory disorder. Characteristic histologic features of IgG4-related lesions include dense fibrosis and abundant lymphoplasmacytic infiltrate, similar to calcifying fibrous tumor. They contain high numbers of IgG4-positive plasma cells in the tissue. Patients also often have elevated serum IgG4 levels. We report the case of a patient with an ileal calcifying fibrous tumor that contained 69 IgG4-positive plasma cells per high-power field and an IgG4-to-IgG ratio of 56% in lesional plasma cells. The patient's serum IgG4 level was 185 mg/dL, more than double the normal value. Altogether, these features suggest that calcifying fibrous tumor could be an unrecognized lesion of IgG4-related disease.
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Affiliation(s)
- Brent K Larson
- Department of Pathology and Laboratory Medicine, Los Angeles, CA, USA
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15
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Li C, Men Y, Gao N, Li L. Calcifying fibrous pseudotumour of the tongue: report of a rare case. Br J Oral Maxillofac Surg 2014; 52:974-6. [PMID: 25216986 DOI: 10.1016/j.bjoms.2014.08.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Accepted: 08/19/2014] [Indexed: 02/05/2023]
Abstract
We describe a rare case of calcifying fibrous pseudotumour of the tongue in a 33-year-old woman.
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Affiliation(s)
- Chunjie Li
- Department of Head and Neck Surgery, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Yi Men
- Department of Head and Neck Surgery, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Ning Gao
- Department of Head and Neck Surgery, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Longjiang Li
- Department of Head and Neck Surgery, State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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16
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Calcifying fibrous tumor of the small intestine associated with Castleman-like lymphadenopathy. J Gastrointest Surg 2014; 18:1205-8. [PMID: 24452381 DOI: 10.1007/s11605-014-2458-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 01/08/2014] [Indexed: 01/31/2023]
Abstract
Calcifying fibrous tumor is a rare mesenchymal tumor that most commonly presents in younger individuals. We report the case of a 25-year-old woman that presented with severe abdominal pain and a small bowel mass at the site of an ileocolic intussusception with associated mesenteric lymphadenopathy. Surgical resection was performed, and pathologic analysis revealed that the mass was a calcifying fibrous tumor associated with Castleman-like adenopathy. This case intends to support a possible association between these two entities.
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17
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Ishii Y, Nakata K, Ohuchida K, Maeyama R, Mitsumoto F, Yamamoto H, Nagai E, Tanaka M. A Calcifying Fibrous Tumor of the Stomach Difficult to Distinguish from Gastrointestinal Stromal Tumor by Preoperative Endoscopic Ultrasonography with a Review of the Literature. THE JAPANESE JOURNAL OF GASTROENTEROLOGICAL SURGERY 2014; 47:268-274. [DOI: 10.5833/jjgs.2013.0061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2025]
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Ogasawara N, Izawa S, Mizuno M, Tanabe A, Ozeki T, Noda H, Takahashi E, Sasaki M, Yokoi T, Kasugai K. Gastric calcifying fibrous tumor removed by endoscopic submucosal dissection. World J Gastrointest Endosc 2013; 5:457-460. [PMID: 24044047 PMCID: PMC3773860 DOI: 10.4253/wjge.v5.i9.457] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 07/01/2013] [Accepted: 08/06/2013] [Indexed: 02/05/2023] Open
Abstract
The World Health Organization describes calcifying fibrous tumors (CFTs) as rare, benign lesions characterized by hypocellular, densely hyalinized collagenization with lymphoplasmacytic infiltration. These tumors rarely involve the gastrointestinal (GI) tract. A routine endoscopic upper gastrointestinal screen detected a 10-mm submucosal tumor (SMT) in the lesser curvature of the lower corpus of the stomach of an apparently healthy, 37-year-old woman with no history of Helicobacter pylori infection. Endoscopic ultrasonography (EUS) localized the internally isoechoic, homogeneous SMT mainly within the submucosa. Malignancy was ruled out using endoscopic submucosal dissection (ESD). A pathological examination confirmed complete resection of the SMT, and defined a hypocellular, spindle-cell tumor with a densely hyalinized, collagenous matrix, scattered lymphoplasmacytic aggregates as well as a few psammomatous, dystrophic calcified foci. The mass was immunohistochemically positive for vimentin and negative for CD117 (c-kit protein), CD34, desmin, smooth muscle actin (SMA) and S100. Therefore, the histological findings were characteristic of a CFT. To date, CFT resection by ESD has not been described. This is the first case report of a gastric calcifying fibrous tumor being completely resected by ESD after endoscopic ultrasonography.
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