Clin Endosc.  2013 May;46(3):284-287. 10.5946/ce.2013.46.3.284.

Gastric Schwannoma Diagnosed by Endoscopic Ultrasonography-Guided Trucut Biopsy

• Hong SW
• Cho WY
• Kim JO
• Chun CG
• Shim KY
• Bok GH
• Um WH
• Lee JE

• KMID: 2048935
• DOI: http://doi.org/10.5946/ce.2013.46.3.284

Abstract

Schwannomas of the gastrointestinal (GI) tract are rare subepithelial tumors comprising approximately 3.3% to 12.8% of all mesenchymal tumors of the GI tract. On endoscopic ultrasound (EUS) they are seen as hypoechoic tumors arising most commonly from the 4th proper muscle layer. Although EUS helps to distinguish tumor characteristics, tissue sampling is required for differentiation with other more common tumors such as GI stromal tumors. Both EUS-guided fine needle aspiration and EUS-guided trucut biopsy (EUS-TCB) can be used for tissue sampling. However, only EUS-TCB allows core biopsy and a high yield of immunohistochemical staining. We report a case of a gastric schwannoma diagnosed by EUS-TCB.

Keyword

Gastric schwannoma; Endoscopic ultrasonography-guided trucut biopsy

MeSH Terms

Biopsy
Biopsy, Fine-Needle
Gastrointestinal Tract
Muscles
Neurilemmoma

Figure

• 

  Fig. 1 (A) Gastroscopy shows a submucosal elevated lesion with bridging fold. (B) Endoscopic ultrasound (EUS) shows a 4 cm-sized hypoehoic mass with internal hyperechogenicity originating from the proper muscle layer. (C) Contrast enhanced computed tomography scan shows a round, enhancing extraluminal-growing mass. (D) EUS-guided Trucut biopsy with 19 gauze needle was performed.

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  Fig. 2 Pathologic findings of Trucut biopsy. Tissue was composed of broad bundles of elongated cells (A, H&E stain, ×100). Immunohistochemistry (IHCS) findings; (B) the tumor strongly stains for S-100 (arrow). IHCS staining for (C) CD 117, (D) CD 34, (E) smooth muscle actin, and (F) desmin are negative (H&E stain, ×100).

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  Fig. 3 Gross specimen of the tumor. The resected specimen shows an unencapsulated homogenous tumor. A Trucut biopsy induced scar (arrow) can be seen.

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