Rare case of an abdominal mass: Reactive nodular fibrous pseudotumor of the stomach encroaching on multiple abdominal organs

Table 1 Antibodies and dilutions used in the evaluation of reactive nodular fibrous pseudotumor

Antibody	Dilution	Source	Antigen retrieval
CK	0.181	Dako	Heat
Actin	0.181	Dako	Heat
CD34	Working solution	Novocastra	Heat
CD117	0.181	Dako	Heat
S-100	0.736	Novocastra	Heat
Desmin	Working solution	Zsjqbio	Heat
DOG-1	0.389	Zsjqbio	Heat
PDGFR	0.181	SANTA CRUI	Heat
Ki-67	0.181	Zsjqbio	Heat
CD3	Working solution	Zsjqbio	Heat
L26	0.736	Dako	Heat
ALK	0.111	Dako	Heat
β-Catenin	0.181	Maixinbio	Heat
CD31	Working solution	Novocastra	Heat
M-CEA	Working solution	Novocastra	Heat

Table 2 Gross anatomopathological characteristic of reactive nodular fibrous pseudotumor reported previously

Ref.	Number of lesion	Size of main lesion (cm)	Morphology	Method of resection	Site of main lesion
2Yantiss et al[1]	Multiple	6.5 in diameter	Firm, tan-white	Complete resection	Mesentery of small intestine
	Single	4.3 in diameter	Ditto	Complete resection	Peripancreas
	Multiple	5.5 in diameter	Ditto	Complete resection	Mesentery of small intestine and large bowel
	Multiple	6.5 in diameter	Ditto	Incomplete resection	Mesentery of small intestine
	Single	2.8 in diameter	Ditto	Complete resection	Mesentery of large bowel
3Daum et al[2]	Single	3.0 in diameter	1	Complete resection	Small intestine
	Single	1	White fibrous, containing an iron pin	Complete resection	Large bowel
	Single	3.0 × 3.0	Fibrous	Complete resection	Large bowel
	Single	10.0 in diameter	Containing a coprolith	Complete resection	Large bowel
	Single	8.0 × 3.0	1	Complete resection	Small intestine
	Single	8.0 in diameter	Yellow-white, elastic	Complete resection	Subserosa and mesentery of large bowel
	Single	4.0 × 7.0 × 2.0	Hard fibrous, containing minute calcifications	Complete resection	Small intestine
	Single	3.0 × 4.0 × 6.0	A small abscess cavity containing foreign bodies	Complete resection	Subserosa of large bowel
Chatelain et al[5]	Single	9.0 in diameter	Firm, white	Complete resection	Mesentery of large bowel
Zardawi et al[7]	Multiple	0.5 × 2.2	Firm, white, containing two gray cord-like structures	Complete resection	Small intestine and the omentum
Saglam et al[8]	Multiple	0.6-6.0 in diameter	Firm, tan to white	Incomplete resection	The pelvic and abdominal peritoneum
Gauchotte et al[6]	Multiple	1.9-2.2 in diameter	Firm, grayish white	Complete resection	Stomach
Yin et al[3]	Single	2.0-3.0 in diameter4	Tan, white, containing calcifications	Complete resection	Mesentery of small intestine
Virgilio et al[9]	Multiple	6.0 × 4.0 × 3.0	Firm, white, containing calcifications	Incomplete resection	Small intestine, hepatic capsule the left paracolic gutter
McAteer et al[4]	Single	8.8 × 3.8 × 2.0	Firm, tan-gray	Complete resection	Mesentery of small intestine

¹No mention in the above articles;

²Containing 5 patients;

³Containing 8 patients;

⁴The data from computed tomography scan.

Table 3 Immunohistochemical findings of reactive nodular fibrous pseudotumor reported previously

Ref.	Vimentin	SMA	Cytokeratin (AE1/AE3)	MSA	Desmin	S-100	CD34	CD117	ALK-1	CK5/6	EMA	CAM5.2	34βE12	CD68	PI
1Yantiss et al[1]	(+) (5/5)	(+) (3/5)	(-) (0/5)	(+) (4/5)	(+) (3/5)	(-) (0/5)	(-) (0/5)	(+) (4/5)	(-) (0/5)			(-) (0/5)
2Daum et al[2]	(+)	Focally (+)	Focally (+)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	< 1.0%
	(+)	(+)	(+)	(+)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	0%
	(+)	Focally (+)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	3.70%
	(+)	(+)	Focally (+)	(+)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	Focally (+)	(-)	(-)	< 1.0%
	(+)	(+)	Focally (+)	(+)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	< 1.0%
	(+)	(+)	Focally (+)	(+)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	(+)	3.50%
	NM	Focally (+)	NM	NM	(-)	(-)	NM	(-)	(-)	NM	NM	NM	NM	NM	< 1.0%
	(+)	Focally (+)	Focally (+)	Focally (+)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	(-)	< 1.0%
3Chatelain et al[5]	(+)							(+)
Zardawi et al[7]	(+)	(+)	(-)		(-)	(-)	(-)	(-)	(-)			(-)
4Saglam et al[8]	(+)	(+)			(-)	(-)	(+)
5Gauchotte et al[6]	(+)	(+)	(+)		(-)	(-)	(-)	(-)	(-)
Virgilio et al[9]	(+)	Focally (+)			(-)	(-)	(-)
6McAteer et al[4]	(+)	(+)	(+)	Focally (+)		(-)	(-)	(-)	(-)

¹Containing 5 patients;

²Containing 8 patients;

³A few stained positive for actin;

⁴Positive for cytokeratin, focally positive with estrogen and progesterone receptors, negative for H-caldesmon;

⁵Negative for neurofilament, synaptophysin, calretinin, caldesmon;

⁶Negative for β-catenin nuclear staining. NM: No mention; SMA: Smooth muscle actin; MSA: Muscle-specific actin; ALK-1: Anaplastic lymphoma kinase-1; EMA: Epithelial membrane antigen; PI: Proliferative index.

Table 4 General information and clinical feature of reactive nodular fibrous pseudotumor reported previously

Ref.	Gender	Age	Presenting symptoms	Medical history	Follow up
Yantiss et al[1]	Male	48	1		No residual disease following surgical resection (mean follow-up 16.3 mo) and one patient who had an incomplete surgical resection had stable disease at 26 mo
	Female	50	1	Abdominal surgical history
	Male	53	Acute abdominal pain	1
	Male	57	Acute abdominal pain	1
	Male	71	1	Abdominal surgical history
Daum et al[2]	Male	59	Abdominal symptoms	1	4 patients are available, without signs of recurrence and metastatic disease 5, 5, 6, and 7 yr, respectively
	Male	46	1
	Male	1	Abdominal symptoms
	Male	68	1
	Female	30	Abdominal symptoms
	Female	65	1
	Male	22	Abdominal symptoms
	Male	41	1
Chatelain et al[5]	Male	32	Chronic abdominal pain	1	1
Zardawi et al[7]	Female	72	1	Abdominal surgical history	1
Saglam et al[8]	Female	28	Chronic abdominal pain	Abdominal history	1
Gauchotte et al[6]	Male	60	1	Abdominal history	No evidence of disease 4 mo later
Yin et al[3]	Male	65	Acute abdominal pain	No abdominal surgical history	1
Virgilio et al[9]	Male	71	1	Abdominal surgical history	No signs of recurrent 4 yr later
Mcateer et al[4]	Female	13	Acute abdominal pain	No abdominal surgical history	1

¹No mention in the above articles.