J Gastric Cancer.  2013 Sep;13(3):192-195.

Gastrointestinal Stromal Tumor with Extensive Lymphatic Metastasis: A Case Report

• Kang KY
• Lee W

Abstract

Gastrointestinal stromal tumor is a rare tumor which arises from the whole gastrointestinal tracts and most of it is detected in the stomach. It is uncommon with small intestine originated gastrointestinal stromal tumor and more uncommon with lymphatic metastasis. We experienced an unusual case of the small bowel gastrointestinal stromal tumor during experimental autopsy. Two primary tumors with central necrosis were detected in the ileum. The sizes of each tumor were 6.1x3.4x4.0 cm and 3.7x4.2x3.2 cm. There was extensive lymphatic metastasis on the greater omentum and mesenteric, iliac lymph nodes were also involved. With histologic findings, the eosinophilic spindle cells were densely distributed. Immunohistochemical findings were CD117 (-), CD34 (+), desmin (-), and S-100 protein (-). Therefore, we diagnosed the tumors as small bowel gastrointestinal stromal tumors with broad lymph node mestasis.

Keyword

Gastrointestinal stromal tumors; Lymph nodes; Neoplasm metastasis

MeSH Terms

Autopsy
Desmin
Eosinophils
Gastrointestinal Stromal Tumors
Gastrointestinal Tract
Ileum
Intestine, Small
Lymph Nodes
Lymphatic Metastasis
Necrosis
Neoplasm Metastasis
Omentum
S100 Proteins
Stomach
Desmin
S100 Proteins

Figure

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  Fig. 1 Removed greater omentum shows numerous tumor masses.

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  Fig. 2 Sectional planes of the first tumor. The cavity resulted from central necrosis is communicated with the intestinal lumen.

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  Fig. 3 Second tumor mass is located under the intact intestinal mucosa.

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  Fig. 4 H&E stain (×200). (A) Spindle tumor cells are arranged in interlacing fascicles. (B) Asterisks indicate the subcapsular sinusoids of the lymph node.

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  Fig. 5 Immunohistochemial stain (×200). (A) Smooth muscle actin is strongly expressed in whole cells of the tumor. (B) CD34 is expressed in the some of the tumor cells.

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