Endoscopic resection of gastric calcifying fibrous tumor: An incidental finding

Shikha Chopra
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Abstract

Calcifying fibrous tumor (CFT) is benign mesenchymal lesion. CFTs of the GI tract are quite rare with less than 60 cases of gastric CFTs reported in the English literature. In a healthy 49 old female, routine Endoscopic ultrasonography (EUS) revealed an internally isoechoic, homogeneous 12mm lesion mainly within the submucosa in the distal body of stomach with no significant past history. An endoscopic submucosal dissection (ESD) was done to rule out malignancy. The histopathological examination showed a hypocellular lesion with few spindle cells interspersed in a hyalinized, collagenous matrix with occasional lymphoplasmacytic cells. Foci of psammomatous, dystrophic calcification were noted. Immunohistochemical examination revealed tumor cells positive for vimentin and negative for CD34, CD117, DOG1, desmin, SMA and S100. Based on histopathological and IHC findings, a diagnosis of gastric calcifying fibrous tumour was made. Only a handful of CFT cases resected by endoscopic submucosal dissection has been reported in the literature. So herein we report a rare case of endoscopically resected gastric calcifying fibrous tumor.
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内镜下胃钙化纤维瘤切除术:偶然发现
钙化纤维瘤是一种良性间质病变。胃肠道的CFTs非常罕见,在英文文献中报道的胃CFTs不到60例。49岁健康老年女性,常规超声内镜检查(EUS)示胃远端黏膜下层一内等回声均匀12mm病变,既往无明显病史。内镜下粘膜剥离(ESD)排除恶性肿瘤。组织病理学检查显示细胞减少,在透明化的胶原基质中散布少量梭形细胞,偶见淋巴浆细胞。可见沙砾性、营养不良性钙化灶。免疫组化检查显示肿瘤细胞vimentin阳性,CD34、CD117、DOG1、desmin、SMA、S100阴性。根据组织病理学和免疫组化结果,诊断为胃钙化纤维瘤。文献中仅报道了少数经内镜下粘膜夹层切除的CFT病例。因此,我们在此报告一例罕见的内镜下切除胃钙化纤维瘤。
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