Quantcast
Skip to main content
Department of Pathology and Laboratory Medicine

Department of Pathology and Laboratory Medicine

Residency Program - Case of the Month

January 2013 - Presented by Brian Gorospe, M.D.

Clinical history:

A 63-year-old female with a past medical history of gastrointestinal bleeding from a gastric ulcer and H. pylori infection presented with new complaints of melena, progressive weakness, fatigue and shortness of breath. Labs were consistent with iron deficiency anemia and a hemoglobin of 3.2 g/dL.  An upper endoscopy revealed a large, ulcerated gastric mass between the incisura and antrum, concerning for malignancy (Figure 1). Abdominal CT scan demonstrated a 9.0 x 6.0 x 5.5 cm multilobulated enhancing mass involving the body and antrum, extending beyond the borders of the stomach (Figure 2).

 

Images:

Figure 1   Figure 2 
Case of the Month, Jan. 2013: Figure 1   Case of the Month, Jan. 2013: Figure 2

 

Endoscopic biopsy: 

An endoscopic biopsy of the gastric mass was performed and included fragments of benign gastric mucosa with ulceration, as well as a small fragment of a poorly differentiated epithelioid neoplasm (Figure 3).

Figure 3
Case of the Month, Jan. 2013: Figure 3

 

Immunohistochemical stains: 

AE1/AE3: positive (figure 4)
CD117: positive (figure 5)
CD45: negative
S100: negative
Desmin: negative
.

Figure 4   Figure 5 
Case of the Month, Jan. 2013: Figure 4   Case of the Month, Jan. 2013: Figure 5

 

ANSWER