Clinicopathological analysis of gastric stromal tumor with primary gastrointestinal carcinoma / 肿瘤研究与临床

Objective To analyze the clinicopathological features of gastric stromal tumor with primary gastrointestinal carcinoma.Methods 469 cases of gastrointestinal stromal tumor (GIST) from January 2011 to December 2014 admitted to PLA General Hospital were retrospectively analyzed.Gastric stromal tumor patients with primary gastrointestinal carcinoma were screened.The concomitant gastrointestinal cancer site,stromal tumor size,mitotic activity,immunohistochemistry were also detected.Results The gastric stromal tumor with primary gastrointestinal carcinoma accounted for 14.7 ％ (69/469) of all the GIST,in which the small gastric stromal tumor accounted for 65.2 ％ (45/69) of the total and 9.59 ％ (45/469) of all the GIST.The diameter of all tumors was ＜ 5 cm,and the mitotic was ＜ 5/50 HPF.The positive rates of CD117,CD34,DOG-1 were 92.8 ％ (64/69),92.8 ％ (64/69),94.1％ (65/69).The Fletcher was classified as low-risk and extreme low-risk.Conclusions Gastric stromal tumor with primary gastrointestinal carcinoma has no specific clinical features and pathological immunohistochemical markers.Its malgnant degree is lower than GIST.Its prognosis is associated with primary gastrointestinal cancer staging.

Primary Malignant Melanoma of the Esophagus: A Case Report

Primary malignant melanoma of the esophagus is extremely rare, with less than 200 cases reported in the literature. However, primary malignant melanoma is an aggressive tumor. We report a case of primary esophageal malignant melanoma that presented with a large polypoid mass in the lower esophagus, and subsequently showed multiple metastatic nodules in the subcutaneous layer, skin and retroperitoneum. Primary malignant melanoma should be included in the differential diagnosis of a polypoid esophageal mass, especially in cases where metastases to unexpected areas occur or in cases of unexpected metastatic patterns.

Nonleukemic Granulocytic Sarcoma of the Ileum: A Case Report

Granulocytic sarcoma is an uncommon clinical condition that usually occurs in the bone, periosteum, soft tissue, lymph node and skin, and this is rarely seen in the gastrointestinal tract. To the best of our knowledge, few cases of granulocytic sarcoma in the small bowel have been reported in the English literature. We present here a case of nonleukemic granulocytic sarcoma of the ileum in a 42-year-old patient who had no evidence of blood or bone marrow involvement that would have been suggestive of acute leukemia or myeloproliferative disorders.

Radiologic Findings of Submucosal Tumors of Gastrointestinal Tract

Gastrointestinal submucosal tumors originate from submucosal histologic structures such as muscles, lymph nodes, nerves, fibers and vessels. Most patients are asymptomatic. Lesions that are large or ulcerated may cause abdominal pain or upper gastrointestinal bleeding, and those that grow intraluminally sometimes become pedunculated and occasionally prolapse to cause intussusception. Adenocarcinoma is the most common primary gastrointestinal tumor, accounting for approximately 90-9 5 % of such lesions, while submucosal tumors account for approximately 2 -6% of all gastrointestinal tumors. Because their overlying mucosa appears normal, submucosal tumors age after difficult to visualize endo-scopically, and for this reason, barium studies or CT scans are helpful for diagnosis. In this paper, variable CT and barium study findings of the different types of gastrointestinal submucosal tumor are demonstrated, and a brief discussion of the respective disease entities is included.

CT Features of Primary Colorectal Signet-Ring Cell Carcinoma

PURPOSE: To evaluate the CT features of 15 patients with primary colorectal signet-ring cell carcinomas. MATERIALS AND METHODS: We retrospectively reviewed the CT scans of 15 patients (mean age, 44 years) with pathologically proven colorectal signet-ring cell carcinoma. The CT findings were evaluated in terms of site and length of the tumor, bowel wall thickening patterns, perirectal or pericolic infiltration, the presence or absence of colonic obstruction, and metastasis to other organs. RESULTS: The tumors were located in the rectum in nine patients, the sigmoid colon in one, the hepatic flexure in one, the transverse colon in one, the ascending colon in two, and the cecum in one. Tumor length ranged from 3.0 to 10.0 (mean, 6.1) cm, with a mean thickness of 2.1 cm. CT revealed concentric bowel wall thickening in all patients, and this was 'even' in eight and 'uneven' in seven. A target appearance was noted in four, perirectal or pericolic infiltration was moderate to severe in 12, and colorectal obstruction was seen in six. With regard to patterns of tumor spread, lymphadenopathy was noted in 13, invasion of adjacent pelvic organs in five, peritoneal carcinomatosis in four, liver metastasis in two, and periureteric metastasis in one. CONCLUSION: When CT shows a long section of concentric bowel wall thickening and a target sign, especially when such findings occur in the rectum and in young patients, primary signet-ring cell carcinoma should be included in the differential diagnosis.

Multiple Lymphomatous Polyposis of the Gastrointestinal Tract: Report of Three Cases

In 1961, Cornes first introduced the term multiple lymphomatous polyposis(MLP), and since then, this very raredisease has been considered as a malignant lymphoma originating in the mantle zone of gastrointestinal lymphoidtissue. MLP presents with a 0.5-2.0cm sized polypoid tumor, which affects long segments of the alimentary tractand frequently invades the mesenteric lymph nodes. It often consists of a dominant mass rather than polyps. Wedescribe three cases of endoscopically proven multiple lymphomatous polyposis, and include a review of theliterature. In differentiating multiple lymphomatous polyposis and other types of multiple polyposis in thegastrointestinal tract, the following features are helpful : the smooth surface of polyps, which is similar to agem seen during a barium examination ; the typical appearance of a gastric submucosal tumor and hypertrophiedgastric mucosal folds in UGI; the presence of enlarged lymph nodes, as seen on abdominal CT scanning.

CT Findings of Mucinous Adenocarcinoma in Gastrointestinal Tract

PURPOSE: To evaluate CT findings of mucinous adenocarcinoma in the gastrointestinal tract. MATERIALS AND METHODS : CT scans of 24 gastric and five colorectal mucinous adenocarcinomas, proven by histology, were retrospectively analysed; the patients consisted of 18 men and 11 women (age range, 27-76; mean, 59). CT findings were analysed, with emphasis on : (a) tumor size and maximal wall thickness ; (b) the presence of a low attenuation area, suggestive of a mucin poll within the tumor ; (c) the presence, shape and location of calcification, and (d) correlation between primary tumor (T) staging and CT findings. RESULTS: The mean tumorsize of gastric mucinous adenocarcinoma was 8.2cm (range, 1.4 - 17cm) and the mean maximal wall thickness was2.3cm (range, 1-4.5cm). Low attenuation areas on enhanced CT were seen in 12 cases (50%). Mottled, punctate, diffuse calcifications were demonstrated in nine cases(38%), and were located in low attenuation areas in eight cases. The T staging could be determined in 22 cases. Of there, low attenuation areas were demonstrated in tencases and calcification in seven. Of those ten cases with low atteuation area T staging was T2 in two cases, T3 intwo, and T4 in six. Of the cases showing calcification, T staging was T3 in one case and T4 in six. The mean sizeof colorectal mucinous adenocarcinoma was 6cm(range, 3-13cm) and the mean maximal wall thickness was 3.6cm (range,1.5-7cm). Low attenuation area were seen in three cases. Mottled calcification within the low sttenuation was detected in one case. The T staging of three cases which showed a low attenuation area was T3 in tow cases and T4in one case. One case with calcification was T3 stage. CONCLUSION: The CT finding of mucinous adenocarcinoma inthe gastrointestinal tract was a relatively thick-walled mass containing an area of low attenuation or calcification. Although calcification is believed to be a pathognomonic finding for the specific diagnosis of mucinous adenocarcinoma, a low attenuation area may be an important CT finding because it can be detected at lower T staging and more frequently.