Stomach - Glomus tumor

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Stomach

Stromal / other tumors

Glomus tumor

Reviewers: Elliot Weisenberg, M.D. (see Reviewers page)
Revised: 13 October 2012, last major update July 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.

General
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● Mesenchymal tumor composed of modified smooth muscle cells; neoplastic counterpart of perivascular glomus bodies
● Common site is distal extremities; rare in GI tract; most common GI site is stomach

Clinical features
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● More common in women, median age 55 years (range, 19-90 years, Am J Surg Pathol 2002;26:301)
● Presents with bleeding (may be life threatening), ulcer symptoms or as incidental finding
● Much less common than GIST
● Usually benign, may metastasize to liver and cause death; malignant behavior more likely if > 5 cm, but cannot predict based on histology

Case reports
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● 55 year old man (Indian J Surg 2011;73:230)
● Multiple tumors involving stomach wall and perigastric adipose tissue (Am J Surg Pathol 1992;16:291)

Gross description
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● 2-5 cm (range, 1.1 to 7 cm) intramural mass, usually antral
● Circumscribed, often with overlying mucosal ulceration and multinodular

Micro description
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● Multiple cellular nodules often separated by streaks of gastric smooth muscle
● Glomus cells are round, sharply demarcated, with cytoplasmic clearing
● Hyaline and myxoid change often in center of tumor
● Mildly dilated pericytoma-like vessels
● Vascular invasion and focal atypia common
● 1-4 mitotic figures/50 HPF

Micro images
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Various images

Positive stains
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● Smooth muscle actin, calponin, h-caldesmon, net-like pericellular laminin and collagen type 4

Negative stains
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● Desmin, S100, chromogranin, CD117/c-kit, CD34 (usually)

Electron microscopy description
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● Cytoplasm packed with myofilaments with focal condensations
● Resembles smooth muscle cells

Differential diagnosis
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● Carcinoid: less prominent cell borders, coarser chromatin, keratin+, chromogranin+, synaptophysin+
● Epithelioid GIST: pericellular clearing, polygonal and not oval/round, less prominent veins/capillaries
● Hemangiopericytoma / solitary fibrous tumor: very rare in GI tract, actin-)
● Paraganglioma: zellballen surrounded by sustentacular cells; chromogranin+, synaptophysin+, S100+

End of Stomach > Stromal / other tumors > Glomus tumor

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