Gastric schwannoma misdiagnosed as gastrointestinal stromal tumor by ultrasonography before surgery: A case report

Figure 1 Conventional abdominal ultrasound examination. A: Gray-scale sonography showed a hypoechoic lesion (orange arrow), size 4.7 cm × 4.4 cm, with clear and regular boundary, between the upper pole of the spleen and the abdominal aorta; B: Color Doppler showed no evident blood flow.

Figure 2 Abdominal computed tomography plain scan and enhancement. A: Plain computed tomography (CT) showed a local soft tissue density mass in gastric wall (orange arrow), smooth boundary, local protrusion outside the contour of the stomach, with surrounding enlarged lymph nodes (white arrow); B: Enhanced CT showed a markedly enhanced mass (orange arrow), with surrounding enlarged lymph nodes (white arrow).

Figure 3 Coronal computed tomography. A: Computed tomography (CT) showed a mass on the fundus of the stomach (orange arrow); B: CT showed enlarged lymph nodes around the mass (orange arrow).

Figure 4 Mass was observed on the fundus of the stomach by endoscopy and endoscopic ultrasound. A: Endoscopy showed a smooth surface of the mass (orange arrow); B: Endoscopic ultrasonography showed a hypoechoic and heterogeneous mass, derived from mucous muscularis, with hyperechoic area (orange arrow); C: Endoscopic ultrasound guided fine needle aspiration. The bright line is the puncture needle (orange arrow).

Figure 5 Postoperative pathology. Hematoxylin and eosin staining. A: A large number of lymphocyte aggregates and lymphoid tissue hyperplasia (40 × magnification) was observed; B: A large number of spindle cells (200 × magnification) was observed.

Figure 6 Procedure for diagnosis and treatment of gastrointestinal stromal tumors. The characteristics and accumulation levels of the mass were observed under transabdominal ultrasonography or endoscopic ultrasonography. CT: Computed tomography; MRI: Magnetic resonance imaging.