Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.
Corresponding author: Ki-Nam Shim, Department of Internal Medicine, Ewha Womans University School of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 158-710, Korea. Tel: 82-2-2650-2632, Fax: 82-2-2655-2076, shimkn@ewha.ac.kr
Gastrointestinal stromal tumors (GISTs) are common mesenchymal tumors that arise in the wall of the gastrointestinal tract. We report a case of obscure gastrointestinal bleeding due to a GIST of the jejunum successfully documented by videocapsule endoscopy (VCE) and single-balloon enteroscopy (SBE). A 36-year-old man with hematochezia was referred for further evaluation of no evidence of bleeding focus on esophagogastroduodenoscopy and colonoscopy. A VCE showed a suspicious ulcerative hyperemic mass that located in about 1 hour apart from duodenal second portion. SBE revealed a nonbleeding 4×2 cm mass with an ulcer at the proximal jejunum. The patient underwent laparoscopic resection without complication. Histological examination revealed a well circumscribed, dumbbell-shaped firm mass comprised of spindle cells. Immunohistochemical staining for CD 117 was diffusely positive, whereas staining for S-100, CD 34 and MIB-1 was all negative. It was confirmed to be a low-grade GIST at the proximal jejunum.
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Fig. 1
Capsule endoscopic finding. It shows a suspicious huge ulcerative hyperemic mass that located in about 1 hour apart from duodenal second portion.
Fig. 2
Single balloon enteroscopic findings. (A) It shows a hyperemic ulcerative mass at proximal jejunum, and (B) the round central ulceration is covered with exudates.
Fig. 3
Pathologic findings. (A) There is a 4.4×2.2 cm sized dumbbell shaped polypoid mass with well defined margin. (B) It is composed of spindle cells with a little mitotic activity (1 mitosis/50 HPF; H&E, ×400). (C) The staining of CD 34 is negative. (D) The staining of CD 117 (c-kit) is positive.
A Case of Jejunal Gastrointestinal Stromal Tumor Diagnosed by Videocapsule Endoscopy and Single-Balloon Enteroscopy
Fig. 1
Capsule endoscopic finding. It shows a suspicious huge ulcerative hyperemic mass that located in about 1 hour apart from duodenal second portion.
Fig. 2
Single balloon enteroscopic findings. (A) It shows a hyperemic ulcerative mass at proximal jejunum, and (B) the round central ulceration is covered with exudates.
Fig. 3
Pathologic findings. (A) There is a 4.4×2.2 cm sized dumbbell shaped polypoid mass with well defined margin. (B) It is composed of spindle cells with a little mitotic activity (1 mitosis/50 HPF; H&E, ×400). (C) The staining of CD 34 is negative. (D) The staining of CD 117 (c-kit) is positive.
Fig. 1
Fig. 2
Fig. 3
A Case of Jejunal Gastrointestinal Stromal Tumor Diagnosed by Videocapsule Endoscopy and Single-Balloon Enteroscopy
