We present a 76-year-old Japanese male who had a history of removal of a gastric gastrointestinal stromal tumor (GIST) 6 years ago. Although asymptomatic and having no evidence of recurrence, follow-up endoscopy revealed a small, white depressed lesion of approximately 1 cm with converging mucosal folds in the greater curvature of the fundus, which was suspicious of depressed-type early gastric cancer (GC) by conventional endoscopy. However, no evidence of GC except a “white globe appearance”-like area was identified by magnifying endoscopy with blue laser imaging. The biopsy specimens showed a proliferation of anaplastic lymphoma kinase (ALK)-positive spindle cells in the gastric mucosa, and ALK-rearrangement was detected by fluorescent in situ hybridization. Furthermore, clathrin heavy chain (CLTC)-ALK fusion was seen by genetic analysis, thus the lesion was preoperatively diagnosed as gastric inflammatory myofibroblastic tumor (IMT). For the curative intent, a laparoscopic endoscopi..... READ ARTICLE
Human Pathology DOI:10.1016/j.ehpc.2018.12.005
Authors: Mai Nakanishi, Jiro Watari, Toshihiko Tomita, Yasutaka Nakanishi, Yoshitane Tsukamoto, Shohei Matsuo, Takashi Uchihashi, Junichi Miyazaki, Hironori Tanaka, Shoudou Kojima, Nobukazu Kuroda,Ikuo Matsuda, Hiroto Miwa, Hisashi Shinohara, Seiichi Hirota