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. 2018 May 18;57(19):2819–2825. doi: 10.2169/internalmedicine.0677-17

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Copyright © 2018 by The Japanese Society of Internal Medicine

The Internal Medicine is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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Figure 3. — Upper gastrointestinal endoscopy. (a) An Ip-type lesion was found in the lumen at 27 to 37 cm from the incisors. The region of origin was suspected to be at 7 o’clock. (b) The mucosa surrounding the lesion was normal, as seen on narrow-band imaging. (c) Pathology of the biopsy specimen showed the proliferation of spindle-shaped tumor cells, and these cells were S100 (focal+), c-kit (-), DOG1 (-), desmin (-), SMA (-), CK AE1/AE3 (-), and CD34 (-). Approximately 40% of the cells were positive for Ki67. The findings were HMB45 (-), Melan-A (-), and negative for malignant melanoma, indicating high-grade spindle cell sarcoma (Hematoxylin and Eosin staining ×100).