Stomach
Stromal / other tumors
Gastroblastoma


Topic Completed: 11 November 2019

Revised: 11 November 2019

Copyright: 2019, PathologyOutlines.com, Inc.

PubMed Search: Gastroblastoma

Diana Agostini-Vulaj, D.O.
Page views in 2019 to date: 140
Cite this page: Agostini-Vulaj D. Gastroblastoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/stomachgastroblastoma.html. Accessed December 10th, 2019.
Definition / general
Essential features
  • Rare biphasic tumor of stomach with epithelial and stromal elements
  • Characteristic fusion gene, MALAT1-GLI1
  • Mostly seen in young adults
ICD coding
Epidemiology
Sites
Etiology
  • Unknown at this time
Clinical features
Diagnosis
  • Imaging followed by tissue diagnosis
Radiology description
Radiology images

Images hosted on other servers:

CT and MRI with multilobulated cystic mass

Prognostic factors
  • Unknown at this time
Case reports
Treatment
Clinical images

Images hosted on other servers:

Lobulated stomach mass

Gross description
Gross images

Images hosted on other servers:

Solid and cystic mass

Variegated mass

Transmural mass

Microscopic (histologic) description
  • Biphasic tumor
    • Spindle cell component demonstrating sheets of monotonous spindled type cells
    • Epithelial component demonstrating cords / clusters of epithelial type cells, some with vague to well-formed gland formation, which may contain inspissated material
  • Relatively low mitotic rate (Am J Surg Pathol 2009;33:1370)
Microscopic (histologic) images

Contributed by Raul S. Gonzalez, M.D. and Rondell P. Graham, M.B.B.S.

Invasive tumor

Epithelial component

Nests of epithelioid cells

Spindle cell component

Positive stains
Negative stains
Electron microscopy description
Electron microscopy images

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Desmosomes and 
microvilli between 
tumor cells

Molecular / cytogenetics description
Molecular / cytogenetics images

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RT-PCR, MALAT1-GLI1 fusion and sequencing

GLI1 FISH
breakapart and
MALAT1-GLI1
fusion FISH

Sample pathology report
  • Stomach, partial gastrectomy:
    • Gastroblastoma (see comment)
    • Comment: H&E sections demonstrate a biphasic tumor with varied intermixed epithelial and stromal elements. The epithelial component is positive for cytokeratin AE1 / AE3 while the stromal component is positive for vimentin. Both components are negative for c-KIT, CD34, desmin, S100, CD99 and SMA. Additional ancillary testing demonstrates the MALAT1-GLI1 fusion gene.
Differential diagnosis
Board review question #1
Which fusion gene typifies gastroblastoma?

  1. ASPL-TFE3
  2. BRAF-KIAA1549
  3. ETV6(TEL)-NTRK3
  4. MALAT1-GLI1
  5. SYT-SSX1
Board review answer #1
D. MALAT1-GLI1

Reference: Stomach - Gastroblastoma

Comment here
Board review question #2
A large gastric antral tumor is excised in a 15 year old male. Histologically you identify 2 differing cellular components, with spindled and epithelioid morphology (see images below). c-KIT, DOG1, SMA, desmin and S100 are negative. This could be which tumor?



  1. Gastroblastoma
  2. Gastrointestinal stromal tumor
  3. Granular cell tumor
  4. Leiomyoma
  5. Schwannoma
Board review answer #2
A. Gastroblastoma

Reference: Stomach - Gastroblastoma

Comment here
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