63 yrs male duodenal biopsy with history of anaemia

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Section shows normal mucosa and lamina propria followed by mass lesion involving sub mucosa later- having moderately cellularity with short fascicles and storiform pattern at places of spindled cells and nesting patten of epitheloid cells with skenoid material in the background. Cells are showing mild nuclear pleomorphism, vesicular chromatin and inconspicuous nucleoli and eosinophilic cytoplasm. Mitosis very scant. Areas of necrosis not seen. O/f/s/o - spindle cell tumor probably of smooth muscle origin having mixed cell types- spindle and epitheloid . S/o- GIST D/d- schwannoma Leiomyoma Adv: c-kit Doc1 S-100 SMA ( to rule out the differentials)

D/d: leiomyosarcoma > leiomyoma

Sections studied show duodenal mucosa with villi lined by glandular epithelium with few goblet cells. Lamina propria shows chronic inflammation. A cellular tumor is present in sub mucosa extending towards serosa. Tumor shows spindle cells arranged in interlacing fascicles and compact bundles. Cells have nuclei with blunt ends and eosinophilic cytoplasm. Vesicular nucleus with atypia and focal necrosis present. Few cells show prominent nucleoli. S/O: leiomyosarcoma duodenum D/D: spindle cell type GIST Adv: IHC smooth muscle actin, CD 117

sections show duodenal tissue. submucosa shows a well circumscribed neoplastic lesion composed of tumor cells arranged in interlacing fascicles cells show elongated nucleus with blunt ends, granular chromatin and moderate amount of pale eosinophilic cytoplasm.s/ o. leiomyoma duodenum. d.d: GIST.

Spindle cell neoplasm.... D/ds... Gist Leiomyosaroma Leiomyoma Advice Ihc like sma, s-100,c-kit

GIST.. Advise DOG1, CD 117 and CD 34 markers

Epithelioid GIST Leiomyoma IHC is mandatory for confirmation

GIST/ leiomyoma

DD - GIST LEIOMYOMA adv IHC CD117 and SMA for confirmation

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