Gastric schwannomas: radiological features with endoscopic and pathological correlation

Hong, H.S.; Ha, H.K.; Won, H.J.; Byun, J.H.; Shin, Y.M.; Kim, A.Y.; Kim, P.N.; Lee, M.-G.; Lee, G.H.; Kim, M.J.

doi:10.1016/j.crad.2007.05.026

« Previous Next »Clinical Radiology
Volume 63, Issue 5 , Pages 536-542, May 2008

Gastric schwannomas: radiological features with endoscopic and pathological correlation

H.S. Hong
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seodaemoon-gu, Seoul, Korea
H.K. Ha
- Department of Radiology, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea
- Guarantor and correspondent: H. K. Ha, Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388–1, Pungnap-2dong, Songpa-gu, Seoul, 138–736, Republic of Korea. Tel.: +82-2-3010-4400; fax: +82-2-476-0090.
H.J. Won
- Department of Radiology, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea
J.H. Byun
- Department of Radiology, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea
Y.M. Shin
- Department of Radiology, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea
A.Y. Kim
- Department of Radiology, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea
P.N. Kim
- Department of Radiology, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea
M.-G. Lee
- Department of Radiology, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea
G.H. Lee
- Internal Medicine, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea
M.J. Kim
- Pathology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea

Received 31 December 2006; received in revised form 17 May 2007; accepted 31 May 2007.

Aim

To describe the radiological, endoscopic, and pathological findings of gastric schwannomas in 16 patients.

Materials and methods

The radiological, endoscopic, and pathological findings of 16 surgically proven cases of gastric schwannoma were retrospectively reviewed. All patients underwent computed tomography (CT) and four patients were evaluated with upper gastrointestinal series. Two radiologists reviewed the CT and upper gastrointestinal series images by consensus with regard to tumour size, contour, margin, and growth pattern, the presence or absence of ulcer, cystic change, and the CT enhancement pattern. Endoscopy was performed in eight of these 16 patients. Six patients underwent endoscopic ultrasonography. Pathological specimens were obtained from and reviewed in all 16 patients. Immunohistochemistry was performed for c-kit, CD34, smooth muscle actin, and S-100 protein.

Results

On radiographic examination, gastric schwannomas appeared as submucosal tumours with the CT features of well-demarcated, homogeneous, and uncommonly ulcerated masses. Endoscopy with endoscopic ultrasonography demonstrated homogeneous, submucosal masses contiguous with the muscularis propria in all six examined cases. On pathological examination, gastric schwannomas appeared as well-circumscribed and homogeneous tumours in the muscularis propria and consisted microscopically of interlacing bundles of spindle cells. Strong positivity for S-100 protein was demonstrated in all 16 cases on immunohistochemistry.

Conclusion

Gastric schwannomas appear as submucosal tumours of the stomach and have well-demarcated and homogeneous features on CT, endoscopic ultrasonography, and gross pathology. Immunohistochemistry consistently reveals positivity for S-100 protein in the tumours.