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Sugimura N, Kubota E, Sasaki M, Fukusada S, Mizuno Y, Iwasaki H, Tanaka M, Ozeki K, Shimura T, Kataoka H. A case of asymptomatic gastric plexiform fibromyxoma followed up for 3 years. DEN OPEN 2024; 4:e291. [PMID: 37731837 PMCID: PMC10508324 DOI: 10.1002/deo2.291] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 08/17/2023] [Accepted: 08/19/2023] [Indexed: 09/22/2023]
Abstract
Plexiform fibromyxoma is a rare mesenchymal tumor identified in recent years and presents as a gastrointestinal submucosal tumor that is typically located in the gastric antrum. We report a case of gastric plexiform fibromyxoma in which the diagnosis was difficult despite repeated tissue sampling. Before visiting our hospital, the patient had been followed up for 3 years without a definitive diagnosis despite serial examinations, including computed tomography, endoscopy, endoscopic ultrasound, and endoscopic ultrasound-guided fine-needle aspiration. Endoscopic ultrasound-guided fine-needle aspiration was reperformed, and endoscopic submucosal dissection for deep biopsy was conducted for differential diagnosis of the tumor. However, histological analysis with immunostaining of tumor samples obtained using these techniques cannot provide a reliable diagnosis. Finally, the tumor was resected surgically because of its increasing size, and subsequent microscopic analysis revealed a multinodular plexiform growth pattern of spindle-like cells with myxoid stroma. Immunohistochemically, the tumor cells were positive for smooth muscle actin but negative for c-kit, CD34, and S100. Based on these findings, the patient was diagnosed with plexiform fibromyxoma. No evidence of residual or recurrent tumors was observed at 24 months postoperatively.
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Affiliation(s)
- Naomi Sugimura
- Department of Gastroenterology and MetabolismNagoya City University Graduate School of Medical SciencesAichiJapan
| | - Eiji Kubota
- Department of Gastroenterology and MetabolismNagoya City University Graduate School of Medical SciencesAichiJapan
| | - Makiko Sasaki
- Department of Gastroenterology and MetabolismNagoya City University Graduate School of Medical SciencesAichiJapan
| | - Shigeki Fukusada
- Department of Gastroenterology and MetabolismNagoya City University Graduate School of Medical SciencesAichiJapan
| | - Yusuke Mizuno
- Department of Gastroenterology and MetabolismNagoya City University Graduate School of Medical SciencesAichiJapan
| | - Hiroyasu Iwasaki
- Department of Gastroenterology and MetabolismNagoya City University Graduate School of Medical SciencesAichiJapan
| | - Mamoru Tanaka
- Department of Gastroenterology and MetabolismNagoya City University Graduate School of Medical SciencesAichiJapan
| | - Keiji Ozeki
- Department of Gastroenterology and MetabolismNagoya City University Graduate School of Medical SciencesAichiJapan
| | - Takaya Shimura
- Department of Gastroenterology and MetabolismNagoya City University Graduate School of Medical SciencesAichiJapan
| | - Hiromi Kataoka
- Department of Gastroenterology and MetabolismNagoya City University Graduate School of Medical SciencesAichiJapan
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2
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Xia Z, Zhou Z, Guo W, Wang H, Wang F, Zhou F. Endoscopic submucosal excavation for gastric plexiform fibromyxoma: A case report and systematic review of literature. Front Oncol 2023; 13:1090259. [PMID: 37035143 PMCID: PMC10080140 DOI: 10.3389/fonc.2023.1090259] [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: 11/05/2022] [Accepted: 03/13/2023] [Indexed: 04/11/2023] Open
Abstract
Plexiform fibromyxoma (PF) is a rare mesenchymal tumor of which the pathogenesis and molecular changes are still unclear. Histologically, it is characterized by a cluster of bland spindle or ovoid cells growing in the mucoid or fibromyxoid stroma rich in small blood vessels. At present, surgical resection is the primary treatment for PF.
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Affiliation(s)
- Ziqin Xia
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Hubei Clinical Center and Key Laboratory for Intestinal and Colorectal Diseases, Wuhan, China
| | - Zhidai Zhou
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Hubei Clinical Center and Key Laboratory for Intestinal and Colorectal Diseases, Wuhan, China
| | - Wei Guo
- Department of Pathology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Hongling Wang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Hubei Clinical Center and Key Laboratory for Intestinal and Colorectal Diseases, Wuhan, China
| | - Fan Wang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Hubei Clinical Center and Key Laboratory for Intestinal and Colorectal Diseases, Wuhan, China
| | - Feng Zhou
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Hubei Clinical Center and Key Laboratory for Intestinal and Colorectal Diseases, Wuhan, China
- *Correspondence: Feng Zhou,
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Wu JD, Chen YX, Luo C, Xu FH, Zhang L, Hou XH, Song J. Plexiform angiomyxoid myofibroblastic tumor treated by endoscopic submucosal dissection: A case report and review of the literature. World J Gastroenterol 2021; 27:5288-5296. [PMID: 34497451 PMCID: PMC8384752 DOI: 10.3748/wjg.v27.i31.5288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/08/2021] [Accepted: 07/26/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Plexiform angiomyxoid myofibroblastic tumor (PAMT) is a rare mesenchymal tumor characterized by multiple nodular plexiform growth patterns and an immunophenotype with myofibroblasts. The pathological characteristics, immunohistochemistry, diagnostic criteria, differential diagnosis, and gene-level changes of PAMT have been reported in many studies. At present, the main treatment for PAMT in the reported cases is surgery; only eight cases were treated via endoscopy (excluding 1 thoracoscopic resection), and the lesions were all smaller than 5 cm. There are no reports on the prognosis and follow-up of young patients with lesion sizes reaching 5 cm who undergo endoscopic submucosal dissection (ESD). Herein, we present the first case of a young patient with a lesion size reaching 5 cm who was diagnosed with PAMT via endoscopic submucosal dissection. CASE SUMMARY A 15-year-old young man with upper abdominal pain for 2 years presented to the Gastroenterology Department of our hospital. Painless gastroscopy showed a semicircular bulge approximately 5 cm in size in the lesser curvature near the cardia of the fundus; the surface was eroded, and shallow ulcers had formed. The pathological manifestations of the biopsy were spindle cell proliferative lesions with interstitial mucinous changes, and the surface mucosa showed chronic inflammatory changes with active lesions; immunohistochemistry showed smooth muscle actin (SMA) (+), CD117 (-), CD34 (-), DOG-1 (-), S-100 (-), and Ki67 (LI: < 1%). We performed ESD on the patient. The lesion that we removed was 5 cm × 4 cm × 2 cm in size. Pathologically, the resected tissue displayed typical manifestations, such as fat spindle-shaped fibroblasts and myofibroblast-like cells showing irregular nodular hyperplasia. Immunohistochemistry staining of the tumor cells revealed the following: CD34 (partially +), SMA (weakly +), CD117 (-), DOG-1 (-), S-100 (-), SDHB (+), PCK (-), and Ki67 (labelling index: 2%). There was no recurrence or metastasis during the 3-mo follow-up after the operation, and the treatment effect was good. We also performed a review of the literature on the clinical manifestations, pathological features, immunohistochemistry, and differential diagnosis of PAMT. CONCLUSION At present, the diagnostic criteria for PAMT are relatively clear, but the pathogenesis and genetic changes require further study. PAMT is benign in nature, and these patients are less likely to experience local or metastatic recurrence. The main treatment is still surgery if the lesion is in the stomach. Partial gastrectomy and distal gastrectomy are the most frequently performed surgical treatments for PAMT, followed by local resection, subtotal gastrectomy, and wedge resection. But for comprehensive evaluation of the disease, ESD can be considered a suitable method to avoid excessive treatment.
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Affiliation(s)
- Jian-Di Wu
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Yi-Xiong Chen
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Chang Luo
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Feng-Hua Xu
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Lei Zhang
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Xiao-Hua Hou
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
| | - Jun Song
- Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China
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Pei JY, Tan B, Liu P, Cao GH, Wang ZS, Qu LL. Gastric plexiform fibromyxoma: A case report. World J Clin Cases 2020; 8:5639-5644. [PMID: 33344555 PMCID: PMC7716332 DOI: 10.12998/wjcc.v8.i22.5639] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 06/16/2020] [Accepted: 09/11/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Plexiform fibromyxoma (PF) is a rare mesenchymal tumor of the stomach. The clinical features of PF frequently include upper abdominal pain, abdominal discomfort, hematemesis, melena, pyloric obstruction and an upper abdominal mass. We herein report a case of PF resected by laparoscopic radical distal gastrectomy plus Roux-en-Y gastrojejunostomy.
CASE SUMMARY The patient was admitted to hospital, due to a 1-wk history of an abdominal space-occupying lesion identified during a health examination. He underwent complete resection by laparoscopic radical distal gastrectomy plus Roux-en-Y gastrojejunostomy. During the operation, the tumor was located in the anterior wall of the gastric antrum (approximately 7 cm × 6 cm × 5.5 cm) and did not show evidence of invasion of the serosa. Histology showed that the tumor cells were oval fibroblast-like and spindle-shaped cells, with numerous thin-walled blood vessels and abundant myxoid stroma. Cellular atypia and mitosis were both rare. Immunohistochemistry showed that the tumor cells were immunoreactive for smooth muscle actin, S-100 and CD-10, but were negative for CD-117, CD-34, DOG-1, and ALK. In this case, S-100 was positive and no significant disease was observed during the follow-up period.
CONCLUSION The fact that PF is a rare tumor with only a few cases in this region can lead to misdiagnosis of this entity and pose a real diagnostic challenge for general surgeons and pathologists when encountering such patients and differentiating PF from other primary tumors of gastric mesenchymal origin. Our report may help increase awareness of this rare, but important new disease entity.
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Affiliation(s)
- Jin-Yu Pei
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266555, Shandong Province, China
- Medical College, Qingdao University, Qingdao 266071, Shandong Province, China
| | - Bin Tan
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266555, Shandong Province, China
| | - Peng Liu
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266555, Shandong Province, China
- Medical College, Qingdao University, Qingdao 266071, Shandong Province, China
| | - Guang-Hua Cao
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266555, Shandong Province, China
- Medical College, Qingdao University, Qingdao 266071, Shandong Province, China
| | - Zu-Sen Wang
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266555, Shandong Province, China
| | - Lin-Lin Qu
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266555, Shandong Province, China
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Gastric Plexiform Fibromyxoma Arising in the Cardia in an Adolescent Male: A Rare Tumor with an Unusual Location. Case Rep Surg 2020; 2020:9037960. [PMID: 33489405 PMCID: PMC7803177 DOI: 10.1155/2020/9037960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 10/17/2020] [Accepted: 10/26/2020] [Indexed: 02/07/2023] Open
Abstract
Plexiform fibromyxoma of the stomach, also known as plexiform angiomyxoid myofibroblastic tumor, is a rare benign gastric mesenchymal tumor, first described in 2007, which usually arises in the gastric antrum and affects adults. Few cases have been reported in children and adolescents. It can present with different clinical manifestations including abdominal pain, dyspepsia, hematemesis, and vomiting. Preoperatively, this tumor is usually diagnosed as gastrointestinal stromal tumor (GIST), and the correct diagnosis is made only after histopathological examination following surgical resection. Most cases were reported from East Asia (China, Japan, and Korea), North America, and Europe. We report herein a unique case of plexiform fibromyxoma, the first to be reported from the Middle East, arising in the cardia of the stomach in a 16-year-old adolescent male, with a brief review of the literature.
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Gan Y, Hammoud G, Esebua M. A rare case of plexiform fibromyxoma in stomach: FNA diagnosis with histological correlation and differential diagnoses. Ann Diagn Pathol 2019; 44:151453. [PMID: 31864161 DOI: 10.1016/j.anndiagpath.2019.151453] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 11/08/2019] [Indexed: 12/13/2022]
Abstract
Plexiform angiomyxoma (PF) is a rare benign mesenchymal neoplasm that arises in the antrum and pyloric region of the stomach. To the best of our knowledge, there are only two prior endoscopic ultrasound guided fine needle aspiration cytology examples have been reported. We report a case of PF which was diagnosed via EUS FNA and later confirmed on resection specimen. Differential diagnoses of this tumor are discussed. Although diagnosis of plexiform fibromyxoma on FNA specimen is difficult, a good FNA specimen with subsequent careful morphological evaluation and immunohistochemical staining work-up makes this task possible.
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Affiliation(s)
- Yujun Gan
- Department of Pathology, University of Missouri, United States of America.
| | - Ghassan Hammoud
- Department of Medicine-Gastroenterology, University Missouri, United States of America
| | - Magda Esebua
- Department of Pathology, University of Missouri, United States of America
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Su HA, Yen HH, Chen CJ. An Update on Clinicopathological and Molecular Features of Plexiform Fibromyxoma. Can J Gastroenterol Hepatol 2019; 2019:3960920. [PMID: 31360694 PMCID: PMC6642755 DOI: 10.1155/2019/3960920] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 06/16/2019] [Indexed: 01/30/2023] Open
Abstract
Plexiform fibromyxoma is a rare and newly described gastric mesenchymal tumor with only 121 reported cases in the literature. Our understanding of plexiform fibromyxoma requires updating since the first case has been reported by Takahashi et al. 12 years ago. The present review summarized reported cases in the literature, and both clinical and pathological aspects of plexiform fibromyxoma were comprehensively discussed. Plexiform fibromyxoma usually causes nonspecific or bleeding signs or symptoms, and therefore clinical recognition of the disease is challenging. Plexiform fibromyxoma is of benign nature without any metastasis or recurrence reported, and more conservative surgical treatment should be considered.
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Affiliation(s)
- Hsuan-An Su
- Department of Medical Education, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Hsu-Heng Yen
- Endoscopy Center, Changhua Christian Hospital, Changhua, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chih-Jung Chen
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Surgical Pathology, Changhua Christian Hospital, Changhua, Taiwan
- Department of Pathology and Laboratory Medicine, Taichung Veterans General Hospital, Taiwan
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8
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Fukazawa M, Koga H, Hiroshige S, Matsumoto T, Nakazono Y, Yoshikawa Y. Pediatric plexiform fibromyxoma: A PRISMA-compliant systematic literature review. Medicine (Baltimore) 2019; 98:e14186. [PMID: 30653169 PMCID: PMC6370170 DOI: 10.1097/md.0000000000014186] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 11/12/2018] [Accepted: 12/26/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Plexiform fibromyxoma (PF) is a rare gastric mesenchymal tumor, with approximately 80 cases reported to date. Gastrointestinal stromal tumor, the most common primary mesenchymal tumor of the stomach, shows different biological and clinical characteristics between adult and pediatric patients. OBJECTIVES This systematic literature review was conducted to elucidate the pathological and clinical features of pediatric PF compared to adult PF. METHODS MEDLINE (1948 to March 2018) and EMBASE (1947 to March 2018) were searched, and all English articles that reported clinical data on PF patients were identified. Two authors independently reviewed the articles and extracted data to assess immunohistochemistry, sex, chief complaint, tumor size, tumor-related mortality, and tumor recurrence and metastasis. RESULTS A total of 41 reports with 80 PF patients (of whom 70 were adult PF and 10 were pediatric PF patients) confirmed by histological and immunohistochemical findings were included. Of a total of 80 tumors, 62 (78%) were located in the gastric antrum, 42 (65%) presented with ulceration, and 48 (74%) were resected by partial gastrectomy. Median tumor size of the resected specimen was larger in pediatric PF than in adult PF cases (5.3 cm vs 4.0 cm, P = .036). However, there was no difference between pediatric and adult PFs in immunohistochemical expression, sex predominance, chief complaint, tumor-related mortality, and tumor recurrence and metastasis during the follow-up periods. CONCLUSION Other than increased tumor growth in pediatric PFs, PF is a single disease entity with similar pathological features and benign clinical behavior regardless of onset age.
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Affiliation(s)
| | | | | | | | - Yuichi Nakazono
- Department of Pathology, National Hospital Organization Beppu Medical Center, 1473 Oaza-Uchikamado, Beppu, Oita, Japan
| | - Yasuji Yoshikawa
- Department of Pathology, National Hospital Organization Beppu Medical Center, 1473 Oaza-Uchikamado, Beppu, Oita, Japan
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Zhang WG, Xu LB, Xiang YN, Duan CH. Plexiform fibromyxoma of the small bowel: A case report. World J Clin Cases 2018; 6:1067-1072. [PMID: 30568965 PMCID: PMC6288503 DOI: 10.12998/wjcc.v6.i15.1067] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 11/05/2018] [Accepted: 11/07/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Plexiform fibromyxoma is a rare, special type of mesenchymal tumor. The most common presenting symptoms are anemia, hematemesis, and hematochezia, without sex or age predilection. The reported cases have mainly occurred in the gastric antrum and pylorus region, with some cases in the duodenum.
CASE SUMMARY We report here a case of plexiform fibromyxoma in the upper segment of the jejunum, which was continuously followed up for 3 years after surgical removal. Plexiform fibromyxoma showed multinodular or plexiform growth. The cells in the tumor node were spindle-shaped but few in number and mitotic figures. Small blood vessels and mucous matrix were found among the tumor cells. Immunohistochemistry revealed that the plexiform fibromyxoma cells were positive for smooth muscle actin, focally positive for CD10, and negative for cytokeratin, CD117, DOG-1 (discovered on GIST-1) desmin, S-100, epithelial membrane antigen, and CD34. Ki-67 labeling index was < 5%. Plexiform fibromyxoma showed benign biological behavior. After 3 years of consecutive postoperative follow-up, no obvious signs of metastasis or recurrence were found by imaging examination.
CONCLUSION Plexiform fibromyxoma is a rare type of mesenchymal tumor. The diagnosis mainly depends on pathological examination, and it should be distinguished from other gastrointestinal mesenchymal tumors.
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Affiliation(s)
- Wei-Guang Zhang
- Department of Endoscopy, the Affiliated Hospital of Guizhou Medical University, Guiyang 550001, Guizhou Province, China
| | - Liang-Bi Xu
- Department of Endoscopy, the Affiliated Hospital of Guizhou Medical University, Guiyang 550001, Guizhou Province, China
| | - Yi-Ning Xiang
- Department of Pathology, the Affiliated Hospital of Guizhou Medical University, Guiyang 550001, Guizhou Province, China
| | - Chen-Hong Duan
- Department of Endoscopy, the Affiliated Hospital of Guizhou Medical University, Guiyang 550001, Guizhou Province, China
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10
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Li X, Li S, Xiong S, Wang Z, Zhang H. A rare case of plexiform angiomyxoid myofibroblastic tumor in the stomach which was diagnosed at the earliest stage in the literature. Gastroenterol Rep (Oxf) 2018; 6:313-316. [PMID: 27940603 PMCID: PMC6225817 DOI: 10.1093/gastro/gow035] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 09/23/2016] [Indexed: 02/05/2023] Open
Abstract
Plexiform angiomyxoid myofibroblastic tumor (PAMT) is a rare gastric mesenchymal entity with a peculiar plexiform pattern, bland spindle cells and myxoid stroma rich in arborizing blood vessels. Here we report a 44-year-old Chinese woman with PAMT. Initially she was admitted for removal of a gastric antral'polyp' found on a routine examination 5 months previously. Our gastroscopy showed a 0.8 × 0.8 cm polyp-like mass in the antrum which protruded into the lumen. Endoscopic submucosal dissection (ESD) was performed to remove this mass en bloc. The specimen was carefully examined by pathologists, and the correct diagnosis of PAMT was finally made. The tumor in this case depicted typical histopathological and immunohistochemical features of gastric PAMT. This PAMT was not only the smallest on endoscopic examination in the literature but also-unlike the already reported PAMTs-exhibited a focal hyperechogenic lesion on endoscopic ultrasonography (EUS). This information highlights its value on how to identify a PAMT at its early stage.
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Affiliation(s)
- Xi Li
- Department of General Practice, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Shuangqing Li
- Department of General Practice, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Shenghua Xiong
- Department of Pathology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Zhujun Wang
- Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Hu Zhang
- Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
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11
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Yang MX, Zhao ZH, Yang JF, Chen B, Shen XZ, Wei JG, Wang BY. Imaging findings of gastric plexiform fibromyxoma with a cystic change: A case report and review of literature. Medicine (Baltimore) 2017; 96:e8967. [PMID: 29384895 PMCID: PMC6392900 DOI: 10.1097/md.0000000000008967] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
RATIONALE Plexiform fibromyxoma (PF) is an extremely rare mesenchymal tumor of the stomach, and its radiological findings have not been well described. Here, we analyzed the imaging features of a case of PF. To our knowledge, this is a rare reported case with a remarkable cystic change in the imaging literature. PATIENT CONCERNS A previously healthy 50-year-old woman presented with a 1-day history of abdominal pain. Then, she underwent computed tomography (CT) and magnetic resonance imaging (MRI). A cystic-solid well-circumscribed extraluminal mass was located in the posterior wall of the gastric upper body. The solid portion appeared as heterogeneous attenuation/intensity with progressive enhancement while the cystic region had no enhancement. DIAGNOSES The potential for malignancy could not be excluded. INTERVENTIONS Laparoscopic partial gastric resection was performed. OUTCOMES Based on pathological findings, a diagnosis of PF was made. The patient was alive without any recurrence or metastasis of the tumor after 2 years of follow-up. LESSONS As far as we know, a gastric PF with a remarkable cystic change has never been reported. Additionally, the tumor exhibited a progressive enhancement pattern which is a characteristic radiographic feature in our case. Our report may help increase the awareness of this rare but important new disease entity.
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Affiliation(s)
| | | | | | | | | | - Jian-Guo Wei
- Department of Pathology, Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, Zhejiang Province, China
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12
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Akai H, Kiryu S, Shinozaki M, Ohta Y, Nakano Y, Yasaka K, Ohtomo K. Computed tomography and magnetic resonance imaging of a plexiform angiomyxoid myofibroblastic tumor: a case report. BMC Med Imaging 2017; 17:7. [PMID: 28103839 PMCID: PMC5244533 DOI: 10.1186/s12880-017-0180-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 01/12/2017] [Indexed: 02/08/2023] Open
Abstract
Background Plexiform angiomyxoid myofibroblastic tumor (PAMT) is a very rare mesenchymal tumor of the stomach. Here we report a case of pathologically confirmed PAMT with an unique cyst formation. Case presentation A 55-year-old male with a 10-year history of a gastric subepithelial tumor underwent computed tomography (CT) and magnetic resonance imaging (MRI). Two cysts were observed in the tumor, and the cyst wall showed moderately high intensity on T2-weighted images compared with the gastric wall. On dynamic study, the cyst wall showed a gradual enhancement pattern, and prominent enhancement was observed in the delayed phase. Laparoscopic partial gastric resection was performed, and a pathological diagnosis of PAMT was rendered. Conclusion We present a rare case of gastric PAMT, which was uniquely presented as cysts. One of the cysts in the tumor had an epithelial wall lining, which had never been reported before in gastric mesenchymal tumor, in addition to partial glandular structure. We reviewed our case, focusing on radiologic-pathologic correlation, and suggested hypothesis of cyst formation. According to our findings, PAMT with cyst formation would be included of differential diagnosis of gastric subepithelial tumors.
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Affiliation(s)
- Hiroyuki Akai
- Department of Radiology, Institute of Medical Science, University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan.
| | - Shigeru Kiryu
- Department of Radiology, Institute of Medical Science, University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan
| | - Masaru Shinozaki
- Department of Surgery, Institute of Medical Science, University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan
| | - Yasunori Ohta
- Department of Pathology, Institute of Medical Science, University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan
| | - Yoshiyasu Nakano
- Department of Radiology, Institute of Medical Science, University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan
| | - Koichiro Yasaka
- Department of Radiology, Institute of Medical Science, University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan
| | - Kuni Ohtomo
- Department of Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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Moris D, Spanou E, Sougioultzis S, Dimitrokallis N, Kalisperati P, Delladetsima I, Felekouras E. Duodenal plexiform fibromyxoma as a cause of obscure upper gastrointestinal bleeding: A case report. Medicine (Baltimore) 2017; 96:e5883. [PMID: 28072751 PMCID: PMC5228711 DOI: 10.1097/md.0000000000005883] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 11/30/2016] [Accepted: 12/17/2016] [Indexed: 02/06/2023] Open
Abstract
RATIONALE We are reporting the first-to our knowledge-case of duodenal Plexiform Fibromyxoma causing obscure upper gastrointestinal bleeding. PATIENT CONCERNS Plexiform fibromyxoma triggered recurrent upper gastrointestinal bleeding episodes in a 63-year-old man who remained undiagnosed, despite multiple hospitalizations, extensive diagnostic workups and surgical interventions (including gastrectomies), for almost 17 years. DIAGNOSES-INTERVENTIONS During hospitalization for the last bleeding episode, an upper gastrointestinal endoscopy revealed an intestinal hemorrhagic nodule. The lesion was deemed unresectable by endoscopic means. An abdominal computerized tomography disclosed no further lesions and surgery was decided. The lesion at operation was found near the edge of the duodenal stump and treated with pancreas-preserving duodenectomy (1st and 2nd portion). OUTCOMES Postoperative recovery was mainly uneventful and a 20-month follow-up finds the patient in good health with no need for blood transfusions.Plexiform fibromyxomas stand for a rare and widely unknown mesenchymal entity. Despite the fact that they closely resemble other gastrointestinal tumors, they distinctly vary in clinical management as well as the histopathology. Clinical awareness and further research are compulsory to elucidate its clinical course and prognosis.
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Affiliation(s)
- Demetrios Moris
- First Department of Surgery
- Department of Immunology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH
| | - Evangelia Spanou
- Department of Pathophysiology, “Laikon” General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Stavros Sougioultzis
- Department of Pathophysiology, “Laikon” General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Polyxeni Kalisperati
- Department of Pathophysiology, “Laikon” General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioanna Delladetsima
- Department of Pathology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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14
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Inoue Y, Gunji S, Obama K, Okabe H, Sakai Y. Laparoscopy endoscopy cooperative surgery for gastric plexiform fibromyxoma: a case report. Surg Case Rep 2016; 2:119. [PMID: 27797068 PMCID: PMC5085966 DOI: 10.1186/s40792-016-0249-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 10/26/2016] [Indexed: 01/15/2023] Open
Abstract
Background Gastric submucosal tumors are commonly treated by partial resection under laparoscopy. However, the surgical resection of gastric submucosal tumors sometimes causes deformation of the stomach, especially in the case of intraluminal tumors located near the pylorus or esophagogastric junction. Such deformations can result in impaired diet intake and reduced quality of life. Laparoscopic endoscopic cooperative surgery has been developed to overcome these problems. This is the first report to describe a case of gastric plexiform fibromyxoma, a rare gastric submucosal tumor, that was successfully resected by laparoscopic endoscopic cooperative surgery. Case presentation A 36-year-old Japanese woman presented with epigastric pain and anemia. Gastrointestinal endoscopy revealed a submucosal tumor in the gastric antrum. Because a definitive diagnosis could not be obtained and the tumor was located near the pylorus, we performed laparoscopic endoscopic cooperative surgery as diagnostic therapy. The postoperative course was favorable with no complications, such as delayed gastric emptying or outlet obstruction. The tumor was pathologically diagnosed as gastric plexiform fibromyxoma. Conclusions Laparoscopic endoscopic cooperative surgery is a useful approach for diagnostic therapy for rare submucosal tumors to avoid the deformation of the stomach, especially when the tumor is located near the pylorus.
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Affiliation(s)
- Yoshikage Inoue
- Department of Surgery, Kyoto University Graduate School of Medicine, Yoshida Konoecho, Sakyo-ku, Kyoto-shi, Kyoto, Japan
| | - Shutaro Gunji
- Department of Surgery, Kyoto University Graduate School of Medicine, Yoshida Konoecho, Sakyo-ku, Kyoto-shi, Kyoto, Japan
| | - Kazutaka Obama
- Department of Surgery, Kyoto University Graduate School of Medicine, Yoshida Konoecho, Sakyo-ku, Kyoto-shi, Kyoto, Japan.
| | - Hiroshi Okabe
- Department of Surgery, Otsu Municipal Hospital, 2-9-9, Motomiya, Otsu-shi, Shiga, Japan
| | - Yoshiharu Sakai
- Department of Surgery, Kyoto University Graduate School of Medicine, Yoshida Konoecho, Sakyo-ku, Kyoto-shi, Kyoto, Japan
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15
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Quero G, Musarra T, Carrato A, Fici M, Martini M, Dei Tos AP, Alfieri S, Ricci R. Unusual focal keratin expression in plexiform angiomyxoid myofibroblastic tumor: A case report and review of the literature. Medicine (Baltimore) 2016; 95:e4207. [PMID: 27428222 PMCID: PMC4956816 DOI: 10.1097/md.0000000000004207] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Plexiform angiomyxoid myofibroblastic tumor (PAMT), also known as plexiform fibromyxoma, is a rare distinctive benign intramural tumor, typical of gastric antrum, commonly causing mucosal ulceration with upper gastrointestinal bleeding and anemia, effectively treated by complete surgical resection usually accomplished by distal gastrectomy. METHODS AND RESULTS We herein report a 47-year-old man presenting with a syncopal episode, regurgitation and epigastric discomfort, bearing a gastric antral myxoid plexiform tumor positive for α-smooth muscle actin, vimentin and, partially, for caldesmon, desmin, and CD10; CD117, DOG1, CD34, S100, CAM5.2, CK20, CK7, EMA, p53, CDX2, chromogranin A, synaptophysin, anaplastic lymphoma kinase, Melan-A, and HMB-45 were all negative. All these features are typical of PAMT. Of note, focal positivity for AE1/AE3 and pan-CK KL1 was also present. CONCLUSIONS The finding of a focal keratin expression in PAMT contributes to enlarge the immunophenotypic spectrum of this tumor type and is relevant for avoiding presurgical misdiagnoses which could ultimately lead to inappropriate overtreatment of patients with PAMT.
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Affiliation(s)
| | | | - Alfredo Carrato
- Department of Gastroenterology and Digestive Endoscopy, “A. Cardarelli” Hospital
| | | | | | - Angelo Paolo Dei Tos
- Department of Medicine, University of Padua School of Medicine, Padua, Italy and Department of Pathology, Treviso Regional Hospital, Treviso, Italy
| | | | - Riccardo Ricci
- Department of Pathology, Catholic University, Rome
- Correspondence: Riccardo Ricci, Department of Pathology, Catholic University, Largo A. Gemelli, 8, I-00168 Rome, Italy (e-mail: )
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16
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Kane JR, Lewis N, Lin R, Villa C, Larson A, Wayne JD, Yeldandi AV, Laskin WB. Plexiform fibromyxoma with cotyledon-like serosal growth: A case report of a rare gastric tumor and review of the literature. Oncol Lett 2016; 11:2189-2194. [PMID: 26998147 DOI: 10.3892/ol.2016.4185] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Accepted: 09/29/2015] [Indexed: 12/14/2022] Open
Abstract
Plexiform fibromyxoma is a rare, benign mesenchymal neoplasm that predilects the gastric antrum and has potential for misdiagnosis as a gastrointestinal stromal tumor (GIST). The histology of the tumor is characterized by interwoven fascicular growth of cytologically bland spindled cells within a variably myxoid stroma. The current study reports the clinicopathological and immunohistochemical findings of a plexiform fibromyxoma resected from a 28-year-old Vietnamese female. The patient presented with acute, severe abdominal pain and worsening anemia. The initial fine-needle aspiration and needle core biopsy of the gastric antral mass led to an initial diagnosis of GIST. The subsequent distal partial gastrectomy revealed a 5.5-cm transmural antral mass that ulcerated the overlying mucosa and grew as variably elongated, myxoedematous, polypoid (cotyledon-like) excrescences from the serosal surface. Microscopically, the tumor demonstrated plexiform and multinodular growth of cytologically bland spindled cells proliferating in an abundant myxocollagenous stroma with a prominent capillary network. Tumor cells immunohistochemically expressed smooth muscle actin and CD10, but did not express CD117, Discovered on GIST-1 or nuclear β-catenin. Follow-up evaluation 23 months post surgery revealed no evidence of residual tumor. A review the cases of this rare entity reported in the English language literature is also provided.
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Affiliation(s)
- Joshua Robert Kane
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Natasha Lewis
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Rebecca Lin
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Celina Villa
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Alexandra Larson
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Jeffrey D Wayne
- Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - Anjana V Yeldandi
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
| | - William B Laskin
- Department of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
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17
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Morris MW, Sullivan L, Sawaya DE, Steiner MA, Nowicki MJ. Gastric plexiform fibromyxoma tumor in a child – Case report and review of the literature. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2016. [DOI: 10.1016/j.epsc.2015.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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18
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Ni Z, Xie XM, Xu H. Plexiform fibromyxoma of the stomach: Report of one case and review of the literature. Shijie Huaren Xiaohua Zazhi 2015; 23:5085-5088. [DOI: 10.11569/wcjd.v23.i31.5085] [Citation(s) in RCA: 3] [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] [Indexed: 02/06/2023] Open
Abstract
Plexiform fibromyxoma (PF) of the stomach is a recently described rare mesenchymal neoplasm of the gastrointestinal tract. Its main clinical features include a peculiar plexiform pattern, bland spindle cells and a myxoid stroma rich in arborizing blood vessels. However, the epidemiology, etiology, pathogenesis, diagnosis and treatment of PF are still not very clear. Here we report a case of plexiform fibromyxoma of the stomach, and we also performed a literature review.
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19
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Dixit JD, Sharief SA, Goyal MK, Khan S, Kauser L. Plexiform Angiomyxoid Myofibroblastic Tumor (PAMT) of Stomach with Synchronous Bilateral Cystic Ovarian Neoplasms, a Rare Case Presentation. Indian J Surg Oncol 2015; 7:82-5. [PMID: 27065688 DOI: 10.1007/s13193-015-0454-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 08/17/2015] [Indexed: 12/16/2022] Open
Abstract
Plexiform Angiomyxoid Myofibroblastic Tumor (PAMT) is a recently identified mesenchymal tumor of the stomach, which was first described in the year 2007 and was added in the 2010 WHO classification of tumors of the digestive system World J Gastroenterol 16(6): 2835-2840, 2010. It closely resembles with other gastric tumors but distinctly varies in clinical management as well as the histopathology. We had a 51 year, female patient, laborer by profession with low socio economic status, who had abdominal pain with vomiting since 6 months. She had similar complaints 3 years ago for which she was evaluated and presumed to have Carcinoma Stomach and underwent laparotomy which ended up only with Gastro- Jejunal anastomosis. She was admitted at our institution. Endoscopy revealed antral bulge with central area ulceration and biopsy was taken which was not confirmatory for malignancy. CT images showed heterogeneous mass with necrotic changes arising from the duodenum favored the diagnosis of perigastric neoplasm. PET CT was done, 8.4 × 5 × 6.1 cm exophytic mass in the pyloric region of stomach with solid and cystic components causing significant gastric outlet obstruction. She underwent exploratory laparotomy and complete excision of mass with achievement of R0 clearance. Histopathology was reported as Plexiform angiomyxoid myofibroblastic tumor (PAMT).
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Affiliation(s)
| | | | | | - Sameeha Khan
- Al-Ameen Medical College, Vijayapur, Karnataka India
| | - Lubna Kauser
- Sri Siddhartha Medical College, Tumakuru, Karnataka India
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20
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Banerjee N, Gupta S, Dash S, Ghosh S. Plexiform angiomyxoid myofibroblastic tumour of the duodenum: a rare entity. BMJ Case Rep 2015. [PMID: 26216925 DOI: 10.1136/bcr-2015-210004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Plexiform angiomyxoid myofibroblastic tumour (PAMT) has recently emerged as a new entity among gastrointestinal mesenchymal tumours. All of the 27 cases reported until now originated from the stomach. We report the first case of a duodenal PAMT arising from the first part of the duodenum in a 19-year-old woman presenting with upper abdominal pain and an abdominal lump.
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Affiliation(s)
- Niladri Banerjee
- Department of Surgery, Medical College, Kolkata, Kolkata, West Bengal, India
| | - Shahana Gupta
- Department of Surgery, Medical College, Kolkata, Kolkata, West Bengal, India
| | - Suvashis Dash
- Department of Surgery, Medical College, Kolkata, Kolkata, West Bengal, India
| | - Shibajyoti Ghosh
- Department of Surgery, Medical College, Kolkata, Kolkata, West Bengal, India
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21
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22
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Duckworth LV, Gonzalez RS, Martelli M, Liu C, Coffin CM, Reith JD. Plexiform fibromyxoma: report of two pediatric cases and review of the literature. Pediatr Dev Pathol 2014; 17:21-7. [PMID: 24160555 DOI: 10.2350/13-09-1373-oa.1] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Plexiform fibromyxoma is a distinctive mesenchymal neoplasm usually arising in the gastric antrum. We report 2 cases of this entity in pediatric patients, including the first case arising in the esophagus. The patients were a 16-year-old female who presented with chest pain and was found on computed tomographic scan to have a midesophageal mass at the level of the carina, and an 11-year-old female with a gastric mass. Both patients underwent surgical resection of their tumors, which histologically exhibited a plexiform growth pattern with multiple nodules in the muscularis propria and infiltrative borders. The nodules were composed of a rich myxoid stroma with bland uniform spindle cells, no mitoses or necrosis, and delicate blood vessels in the background. Immunohistochemical studies demonstrated that the tumor cells were immunoreactive with smooth muscle actin and not reactive with S-100, CD34, desmin, and c-kit (CD117). We report the first case of plexiform fibromyxoma originating in the esophagus, emphasize its occurrence in pediatric patients, and review the related literature.
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Affiliation(s)
- Lizette Vila Duckworth
- 1 Department of Pathology, Immunology, and Laboratory Medicine; University of Florida, 1600 SW Archer Road PO Box 100275, Gainesville, FL 32610-0275, USA
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23
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Abstract
Recently the so-called plexiform angiomyxoid myofibroblastic tumors (PAMT) have emerged as a new entity of gastric soft tissue tumors and the light microscopic and immunohistological characteristics have now been well described. Until now PAMTs have not yet been reported in the German speaking literature. Worthy of note is that PAMTs can be diagnosed safely in sufficient biopsy material which enables adequate therapeutic steps to be initiated without delay, because PMATs although considered to be benign, can cause serious complications.
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24
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Kang Y, Jung W, Do IG, Lee EJ, Lee MH, Kim KM, Choi J. Plexiform angiomyxoid myofibroblastic tumor of the stomach: report of two cases and review of the literature. KOREAN JOURNAL OF PATHOLOGY 2012; 46:292-6. [PMID: 23110018 PMCID: PMC3479767 DOI: 10.4132/koreanjpathol.2012.46.3.292] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Revised: 06/15/2011] [Accepted: 06/16/2011] [Indexed: 12/14/2022]
Abstract
Plexiform angiomyxoid myofibroblastic tumor (PAMT) of the stomach is a recently recognized entity. Because of its rarity, only 22 cases have been reported in the English-language literature and most of these are single case reports. We report two cases of gastric PAMT. The tumor cells were bland and plexiform arranged in a myxoid stroma, which was positive for alcian blue. Immunohistochemically, the tumor cells were positive for smooth muscle actin, but negative for c-kit, CD34, desmin, S-100 protein, epithelial membrane antigen, neurofilament, and protein kinase C-theta. Mutation analyses for exon 9, 11, 13, and 17 of KIT genes and 12, 14, and 18 of the platelet-derived growth factor receptor alpha (PDGFRA) genes were performed and the tumors were wild-type for mutation.
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Affiliation(s)
- Youngran Kang
- Department of Pathology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
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25
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Choi HS, Chun HJ, Kim I. An unusual submucosal tumor of the stomach. Gastroenterology 2012; 142:e11-2. [PMID: 22370214 DOI: 10.1053/j.gastro.2011.10.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Accepted: 10/12/2011] [Indexed: 01/29/2023]
Affiliation(s)
- Hyuk Soon Choi
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Korea
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