1/28. Malignant fibrothecomatous tumour of the ovary: diagnostic value of anti-inhibin immunostaining.Malignant ovarian tumours of the fibrothecoma group are rare. The clinicopathological features of a case of ovarian malignant fibrothecoma in which there was metastatic disease in the small intestine and peritoneum at presentation are described. A number of differential diagnoses were considered but positive immunohistochemical staining of the resected ovarian and small intestinal neoplasms with anti-inhibin was of value in confirming a sex cord-stromal tumour and in excluding other lesions. The two tumours were also ultrastructurally identical. Classical malignant fibrothecomas are said to show four or more mitotic figures per 10 high power fields (HPF). Although the intestinal secondary was mitotically active, the primary ovarian tumour contained only one to two mitoses per 10 HPF, showing that formal mitotic counts are not an absolute indicator of malignant behaviour in this group of tumours.- - - - - - - - - - ranking = 1keywords = stromal tumour, stromal (Clic here for more details about this article) |
2/28. Coincidence of Crohn's disease and a high-risk gastrointestinal stromal tumor of the terminal ileum.A 51-year-old male patient presented with characteristic radiologic features of Crohn's disease in the terminal ileum plus a large tumorous lesion in the right lower abdomen. Because of rapid crescent symptoms of bowel obstruction, the patient underwent surgery revealing a high-risk gastrointestinal stromal tumor (GIST) of the terminal ileum within an area of Crohn's ileitis. Whereas the association of chronic inflammatory bowel disease (IBD) and gastrointestinal adenocarcinoma is well known, other primary intestinal tumors are rare in these patients, particularly at the time of onset of clinical symptoms. This is the 3rd patient reported in the literature with a sarcoma complicating IBD, and in fact, the first description of the coincidence of Crohn's disease and GIST. Though the present case is likely to be a mere coincidence of two pathologically distinct entities (without any potential causal relationship), it should remind one of the possibility of small bowel 'Crohn's carcinoma' in patients with a sudden change in symptomatology as well as in those in whom intestinal obstruction fails to resolve with adequate therapy.- - - - - - - - - - ranking = 20.311194551818keywords = gastrointestinal stromal, stromal (Clic here for more details about this article) |
3/28. Laparoscopic-assisted resection of a bleeding gastrointestinal stromal tumor.The authors report a case of a 29-year-old male patient with a severe lower gastrointestinal hemorrhage in whom a successful laparoscopic diagnosis and resection (assisted) of an ileal gastrointestinal stromal tumor (GIST) was performed. laparoscopy can be very useful in the diagnosis and treatment of selected cases of lower gastrointestinal bleeding.- - - - - - - - - - ranking = 20.311194551818keywords = gastrointestinal stromal, stromal (Clic here for more details about this article) |
4/28. Carcinoid-related angiomatous polyposis simulating crohn disease.Polyposis associated with ileal carcinoid tumors is a rarely described pathologic mucosal transformation that may simulate inflammatory or neoplastic polyps. We describe a case with innumerable sessile polyps and groups of large filiform-like polyps of the terminal ileum associated with submucosal carcinoid tumors and a large mesenteric carcinoid tumor mass. The clinical, radiographic, and endoscopic presentation of the polyposis, together with the presence of multiple small bowel stenotic lesions, simulated crohn disease. We propose the descriptive terminology angiomatous polyposis to describe the striking microscopic vascular proliferation that characterizes these polyps. The distribution of these lesions, with the most profuse polyposis in the immediate proximity of the carcinoid nests, and the immunohistochemical demonstration of growth factor substances, such as transforming growth factor alpha within neoplastic cells and adjacent polyps, suggest a tumor factor-mediated stromal proliferation.- - - - - - - - - - ranking = 0.041325467118316keywords = stromal (Clic here for more details about this article) |
5/28. Gastrointestinal stromal tumor with skeinoid fibers of the ileum.Gastrointestinal stromal tumor (GIST) is not uncommon among gastrointestinal nonepithelial tumors, but there are few reports describing the cytologic findings. We report a case of GIST with skeinoid fibers in scrape cytology preparation. The patient was a 53-year-old man with a tumor in the small intestine. Scrape preparations from the cut surface of the resected tumor revealed cellular material composed of spindle cells showing loose clusters or single cells. The nuclei were spindled, elongated or cigar-shaped, and relatively uniform. The cytoplasm was fragile and demonstrated a finely fibrillar material. Dense hyaline materials with irregular outline were observed within the loose clusters composed of the tumor cells. The hyaline materials were also observed in the background. Histologic preparation showed spindle cells arranged in a fascicular or storiform pattern. Most eosinophilic globules were distributed between the tumor cells. The globules were positive in periodic acid-schiff reaction, and were stained blue with Masson's trichrome stain. Immunohistochemically, the tumor cells were strongly and diffusely positive for c-kit, focally and weakly positive for alpha-smooth muscle actin, and negative for CD34 and S-100 protein. We emphasize that skeinoid fibers are characteristic of GIST arising in the small intestine, and their presence predicts a good prognosis, even in malignant GIST.- - - - - - - - - - ranking = 0.20662733559158keywords = stromal (Clic here for more details about this article) |
6/28. Gastro-intestinal stromal tumor (GIST): case report.Gastro-intestinal stromal tumors (GISTs), as currently defined, represent the largest category of primary non epithelial neoplasms of the gastrointestinal tract. They arise from mesenchymal cells located in the wall of the organ and show a remarkable variability in their differentiation pathways. For this reason there is relevant degree of confusion in their interpretation. On the basis of immunohistochemical and ultrastructural studies these neoplasms are divided into several categories: leiomyomas, schwannomas and less differentiated tumors referred as GIST. In the small bowel GIST are uncommon. Usually asymptomatic, they could be the cause of surgical emergencies like massive bleeding, obstruction, intussusception or perforation. Generally benign, an higher percentage of malignant cases are described in the small bowel. The Authors report a case of malignant GIST of the small intestine presented with bowel obstruction by ileal invagination. In this case, as usually it happens in malignant GIST, the final diagnosis was obtained by an abdominal surgical exploration.- - - - - - - - - - ranking = 0.20662733559158keywords = stromal (Clic here for more details about this article) |
7/28. Stromal tumour within a Meckel's diverticulum: CT and ultrasound findings.The incidence of tumours within a Meckel's diverticulum is 0.5-3.2%. Their pre-operative diagnosis is rare. We report a case of an incidentally found gastrointestinal stromal tumour within a Meckel's diverticulum in a patient presenting with acute appendicitis. The tumour was demonstrated pre-operatively by ultrasound and CT.- - - - - - - - - - ranking = 11.508824080528keywords = gastrointestinal stromal tumour, gastrointestinal stromal, stromal tumour, stromal (Clic here for more details about this article) |
8/28. Mixed neuronal-glial tumor of the digestive tract: distinctive entity from gastrointestinal stromal tumor?A 53-year-old-woman presenting with pelvic discomfort was found to have a 9.5 cm tumor located in the wall of the ileon. light microscopy showed that the tumor was made of fascicles of plump spindle cells and bizarre epithelioid cells. A cuff of lymphoid cells was also present at the tumor margin. The tumor cells strongly expressed tau protein, neuron-specific enolase, protein green product 9.5 and glial fibrillary acid protein (GFAP), but did not show positive immunostaining for S-100 protein, CD34 or CD117. The tumor showed unequivocal ultrastructural evidence of neural differentiation. Skeinoid fibers were scattered throughout the tumor. This is the first mixed neuronal-glial tumor of the digestive tract to be described in the literature. Such histological and immunohistochemical features could be misinterpreted as features of digestive schwannoma. We suggest that this tumor is distinct from gastrointestinal stromal tumors in lacking CD34 and CD117 expression.- - - - - - - - - - ranking = 20.311194551818keywords = gastrointestinal stromal, stromal (Clic here for more details about this article) |
9/28. Stromal tumor in a perforated Meckel's diverticulum: a case report.Stromal tumors are rare neoplasms of the small bowel that locate in Meckel's diverticulum with high preference. Perforation of those tumors is very uncommon. There are 96 cases reported in current literature, including only 6 perforations. The diagnosis of that kind of tumor is very difficult because of lack of pathognomonic signs and symptoms. The clinical presentation include abdominal pain, intestinal bleeding, abdominal mass, intestinal obstruction and less commonly, acute perforation. We report the case of a 61-years old patient with a poorly differentiated stromal tumor in a perforated Meckel's diverticulum. The difficulty of identifying a stromal tumor preoperatively and the therapeutic options are emphasised. It is suggested that an aggressive attitude should be taken in the preoperative management of any patient over 50 years of age who presents with melena and abdominal pain.- - - - - - - - - - ranking = 0.082650934236633keywords = stromal (Clic here for more details about this article) |
10/28. Small-bowel tumors diagnosed by wireless capsule endoscopy: report of five cases.Tumors of the small bowel, both benign and malignant, are relatively uncommon. As the symptoms are vague and conventional diagnostic tests are unsatisfactory, these tumors often present a clinical, radiological, and endoscopic challenge. We report here on five patients in whom small-bowel tumors were diagnosed using wireless capsule endoscopy. The indications for capsule endoscopy were: obscure gastrointestinal bleeding in four patients (one jejunal capillary hemangioma, one ileal hemangiosarcoma, and two jejunal gastrointestinal stromal tumors) and chronic abdominal pain in one patient (ileal carcinoid). Wireless capsule endoscopy, a new endoscopic method, promises to improve the diagnosis of deep small-bowel pathology.- - - - - - - - - - ranking = 4.0622389103635keywords = gastrointestinal stromal, stromal (Clic here for more details about this article) |
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