Xanthogranulomatous gastritis with pseudosarcomatous changes

Reported herein is a rare case of xanthogranulomatous inflammation of the gastric wall occurring in a 77‐year‐old man. Two submucosal lesions presented as rapidly enlarging nodules, and biopsy showed interweaving bundles of spindle cells with numerous atypical cells with marked nuclear pleomorphism....

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Bibliographic Details
Published in:Pathology international 2007-05, Vol.57 (5), p.291-295
Main Authors: Kubosawa, Hitoshi, Yano, Kentaro, Oda, Kenji, Shiobara, Masayuki, Ando, Katsuhiko, Nunomura, Masao, Sarashina, Hiromi
Format: Article
Language:English
Subjects:
Aged
Antigens, CD - analysis
Antigens, Differentiation, Myelomonocytic - analysis
Diagnosis, Differential
Diagnostic Errors
gastritis
Gastritis - metabolism
Gastritis - pathology
Gastrointestinal Stromal Tumors - pathology
Granuloma - metabolism
Granuloma - pathology
Humans
Immunohistochemistry
Ki-67 Antigen - analysis
Male
pseudosarcomatous changes
Sarcoma - pathology
xanthogranulomatous inflammation
Xanthomatosis - metabolism
Xanthomatosis - pathology
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Summary:Reported herein is a rare case of xanthogranulomatous inflammation of the gastric wall occurring in a 77‐year‐old man. Two submucosal lesions presented as rapidly enlarging nodules, and biopsy showed interweaving bundles of spindle cells with numerous atypical cells with marked nuclear pleomorphism. The differential diagnosis from mesenchymal malignancies, particularly from a malignant gastrointestinal stromal tumor, was difficult and immunohistochemical investigations could not improve the diagnostic accuracy of HE histology alone. Thus, an erroneous diagnosis of malignancy was made and a partial gastrectomy was performed. On macroscopic examination of the resected material, spontaneous regression of the lesions was observed and microscopic examination showed characteristic features of xanthogranulomatous inflammation; large numbers of foamy histiocytes including multinucleated giant cells were admixed with chronic inflammatory cells and fibrous reaction. Although the precise pathogenesis could not be elucidated, recognition of this unusual morphological appearance is of importance to avoid an overdiagnosis of malignancy.
ISSN:1320-5463
1440-1827
DOI:10.1111/j.1440-1827.2007.02089.x