{"id":45036,"date":"2025-08-05T14:04:21","date_gmt":"2025-08-05T06:04:21","guid":{"rendered":"https:\/\/medicine.nus.edu.sg\/pathweb\/?page_id=45036"},"modified":"2026-04-23T14:21:37","modified_gmt":"2026-04-23T06:21:37","slug":"eus-fna-2","status":"publish","type":"page","link":"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/cyto-mystery-cases\/eus-fna-2\/","title":{"rendered":"Mystery cases &#8211; EUS-FNA 2"},"content":{"rendered":"\n<h2>\n\t\tEUS-FNA CASE 2\n\t<\/h2>\n\t<h1>Gastric wall mass<\/h1>\n\t<p><strong>Clinical history<\/strong>: A 53-year-old lady presented with 3-month history of dysphagia. A CT scan of her thorax revealed a submucosal mass at the gastro-oesophageal junction. Endoscopic ultrasound-guided fine needle aspirate obtained the following smear.<\/p>\n\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/06\/eus-fna-3.jpg\" alt=\"EUS-FNA 2\" itemprop=\"image\" height=\"768\" width=\"768\" title=\"eus-fna 3\" onerror=\"this.style.display='none'\"  \/>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-0\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-0\">Cytologic findings<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-0\" tabindex=\"-1\"><i title=\"Expand\">Expand<\/i><\/a>\n\t\t\t\t\t<p>&nbsp;<\/p>\n<table>\n<tbody>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/06\/eus-fna-4.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>Three differentials to consider: GIST, Smooth muscle tumour (Leiomyoma), Schwannoma<\/p>\n<p>Similarities include:<\/p>\n<ul>\n<li>Fascicular arrangement<\/li>\n<li>Spindle cells<\/li>\n<li>Uniform nuclei<\/li>\n<\/ul>\n<table cellspacing=\"0\" cellpadding=\"0\" height=\"176\">\n<tbody>\n<tr>\n<td valign=\"top\"><\/td>\n<td valign=\"top\"><strong>GIST<\/strong><\/td>\n<td valign=\"top\"><strong>Leiomyoma<\/strong><\/td>\n<td valign=\"top\"><strong>Schwannoma<\/strong><\/td>\n<\/tr>\n<tr>\n<td valign=\"top\">Cellularity<\/td>\n<td valign=\"top\">Intermediate to high<\/td>\n<td valign=\"top\">Low to intermediate<\/td>\n<td valign=\"top\">Low to intermediate<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\">Background<\/td>\n<td valign=\"top\">Clean, occasional naked nuclei<\/td>\n<td valign=\"top\">Clean<\/td>\n<td valign=\"top\">Lymphoid-rich, especially in the GIT<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\">Nuclear atypia<\/td>\n<td valign=\"top\">Minimal<\/td>\n<td valign=\"top\">Minimal<\/td>\n<td valign=\"top\">Focal to minimal (ancient change)<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\">Nucleus<\/td>\n<td valign=\"top\">Elongated with blunt ends<\/td>\n<td valign=\"top\">Elongated with blunt ends<\/td>\n<td valign=\"top\">Elongated with pointed ends<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\">Cytoplasm<\/td>\n<td valign=\"top\">Scant, fibrillary<\/td>\n<td valign=\"top\">Moderate amounts<\/td>\n<td valign=\"top\">Scant, fibrillary<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-1\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-1\">Immunohistochemistry<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-1\" tabindex=\"-1\"><i title=\"Expand\">Expand<\/i><\/a>\n\t\t\t\t\t<p>&nbsp;<\/p>\n<table>\n<tbody>\n<tr>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/06\/eus-fna-5.jpg\" alt=\"\" \/><\/td>\n<td><img decoding=\"async\" src=\"https:\/\/medicine.nus.edu.sg\/pathweb\/wp-content\/uploads\/2025\/06\/eus-fna-6.jpg\" alt=\"\" \/><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<table width=\"599\" cellspacing=\"0\" cellpadding=\"0\">\n<tbody>\n<tr>\n<td valign=\"top\"><\/td>\n<td valign=\"top\">\n<p><strong>GIST<\/strong><\/p>\n<\/td>\n<td valign=\"top\">\n<p><strong>Leiomyoma<\/strong><\/p>\n<\/td>\n<td valign=\"top\">\n<p><strong>Schwannoma<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\">\n<p>CD117 (C-Kit)<\/p>\n<\/td>\n<td valign=\"top\">\n<p>+<\/p>\n<\/td>\n<td valign=\"top\">\n<p>&#8211;<\/p>\n<\/td>\n<td valign=\"top\">\n<p>&#8211;<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\">\n<p>DOG1<\/p>\n<\/td>\n<td valign=\"top\">\n<p>+<\/p>\n<\/td>\n<td valign=\"top\">\n<p>&#8211;<\/p>\n<\/td>\n<td valign=\"top\">\n<p>&#8211;<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\">\n<p>CD34<\/p>\n<\/td>\n<td valign=\"top\">\n<p>+<\/p>\n<\/td>\n<td valign=\"top\">\n<p>&#8211;<\/p>\n<\/td>\n<td valign=\"top\">\n<p>&#8211;<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\">\n<p>SMA, desmin<\/p>\n<\/td>\n<td valign=\"top\">\n<p>&#8211;<\/p>\n<\/td>\n<td valign=\"top\">\n<p>+<\/p>\n<\/td>\n<td valign=\"top\">\n<p>&#8211;<\/p>\n<\/td>\n<\/tr>\n<tr>\n<td valign=\"top\">\n<p>S100<\/p>\n<\/td>\n<td valign=\"top\">\n<p>&#8211;<\/p>\n<\/td>\n<td valign=\"top\">\n<p>&#8211;<\/p>\n<\/td>\n<td valign=\"top\">\n<p>+<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--label-2\" tabindex=\"0\" aria-controls=\"fl-accordion--panel-2\">Diagnosis<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<a href=\"#\" id=\"fl-accordion--icon-2\" tabindex=\"-1\"><i title=\"Expand\">Expand<\/i><\/a>\n\t\t\t\t\t&nbsp;<br \/>\n<strong>Gastrointestinal stromal tumour<\/strong>\n\t<p><em>Case writer: Dr Noel Chia<\/em><\/p>\n\n","protected":false},"excerpt":{"rendered":"<p>EUS-FNA CASE 2 Gastric wall mass Clinical history: A 53-year-old lady presented with 3-month history of dysphagia. A CT scan of her thorax revealed a submucosal mass at the gastro-oesophageal junction. Endoscopic ultrasound-guided fine needle aspirate obtained the following smear. Cytologic findings Expand &nbsp; Three differentials to consider: GIST, Smooth muscle tumour (Leiomyoma), Schwannoma Similarities [&hellip;]<\/p>\n","protected":false},"author":828,"featured_media":0,"parent":44933,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-45036","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>NUS Pathweb<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/medicine.nus.edu.sg\/pathweb\/cytopath\/cyto-mystery-cases\/eus-fna-2\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:description\" content=\"EUS-FNA CASE 2 Gastric wall mass Clinical history: A 53-year-old lady presented with 3-month history of dysphagia. 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