Fine‐needle aspiration biopsy of a glomus tumor of the stomach

Abstract

A glomus tumor of the stomach was found as an incidental finding on routine ultrasound in a 72-yr-old asymptomatic woman. A fine-needle aspiration biopsy (FNAB) was performed and was initially interpreted as a well-differentiated neuroendocrine neoplasm, possibly a carcinoid tumor. The aspirate revealed tightly packed nests or clusters of uniform, small, round to polygonal cells with scanty, faintly eosinophilic or clear cytoplasm and ill-defined cell borders. The nuclei were uniform, and round to oval, and contained a granular chromatin pattern and inconspicuous nucleoli. Very occasional intranuclear cytoplasmic inclusions were seen. Laparotomy and a wedge resection of the stomach were performed. The surgical pathology findings revealed a glomus tumor which was confirmed by immunohistochemical stains and ultrastructural studies. Since glomus tumors of the stomach are essentially benign and are amenable to conservative excision, it is important to separate them, preoperatively, from more aggressive gastric neoplasms. FNAB offers a rapid, cost-effective method of diagnosing this entity. We present the cytological, histological, ultrastructural, and immunocytochemical features of this particular gastric neoplasm, along with differential diagnoses.

Diagnosis of Gastric Glomus Tumor by Endoscopic Ultrasound–Guided Fine Needle Aspiration Biopsy

“…6 The cellular aspirate showed tightly packed nests or clusters of relatively small round to polygonal cells. The nuclei were round to oval and uniform, with granular chromatin and inconspicuous nucleoli.…”

“…To our knowledge there has only been two case reports to date in the Englishlanguage literature. 5,6 Unfortunately, both cases were initially misdiagnosed on cytology. With the increasing application and popularity of FNA biopsy, it is important to recognize the cytologic features of glomus tumor in order to avoid unnecessary, aggressive therapy, as required for other, malignant entities.…”

“…[2][3][4] While the histology of glomus tumor is very characteristic and usually does not pose a diagnostic difficulty, the cytologic features of glomus tumor have been poorly defined and rarely reported. 5,6 We report a case of gastric glomus tumor diagnosed by endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) biopsy and later confirmed by histology.…”

Glomus tumor of the stomach: Cytologic diagnosis by endoscopic ultrasound‐guided fine‐needle aspiration

“…Nearly all tumors express muscle actin isoforms and vimentin. 2,5,6 Expression of desmin is variable, and tumors are negative for chromogranin, neuron-specific enolase (NSE), factor VIII-related antigen, keratin, carcinoembryonic antigen (CEA), and epithelial membrane antigen (EMA). 2,5,6 Ultrastructurally, cytoplasmic features of GT cells include dense bodies and peripheral adhesive bodies composed of actinlike filaments, numerous pinocytotic vesicles, and modest numbers of mitochondria, polysomes, and endoplasmic reticulum.…”

“…2,5,6 Expression of desmin is variable, and tumors are negative for chromogranin, neuron-specific enolase (NSE), factor VIII-related antigen, keratin, carcinoembryonic antigen (CEA), and epithelial membrane antigen (EMA). 2,5,6 Ultrastructurally, cytoplasmic features of GT cells include dense bodies and peripheral adhesive bodies composed of actinlike filaments, numerous pinocytotic vesicles, and modest numbers of mitochondria, polysomes, and endoplasmic reticulum. 2,7 Although GTs have predilection for the skin of the distal fingers and toes, especially under the nails, other reported anatomic sites include bone and joints, skeletal muscle, soft tissue, mediastinum, trachea, kidney, uterus, vagina, and stomach.…”