Visit: Gastrointestinal Stromal Tumour

Age- Usually occurs in middle aged and elderly patients, presenting  with dysphagia and heartburn.

Site-  Distal third of esophagus. Tiny  'seedling leiomyoma'  is a common incidental finding at  the cardioesophageal junction,in autopsy cases.

Gross-    Images:1   2

The tumour arises from the smooth muscle coat of the esophagus as a sessile or pedunculated , polypoidal, exophytic intraluminal solid, grayish white whorled cut surface. Focal calcification is sometimes noted. Secondary ulceration may be present. 
Rarely the tumour presents as a lobulated extramural mediastinal mass.

Microscopic features- 

The tumour, like in other sites, is composed of interlacing bundles of smooth muscle cells. The cells are smooth muscle actin and desmin positive.
Features indicating malignancy-
       -Tumour size more than 5cm in diameter
       - Mitosis more 5 per 10 HPF
       -Presence of necrosis and haemorrhage

Image:       

Abstracts:

Esophageal leiomyoma: a 40-year experience.Ann Thorac Surg. 2005 Apr;79(4):1122-5.

Giant leiomyoma of the esophagus. Eur J Cardiothorac Surg. 2002 Dec;22(6):1008-10.

Leiomyoma of the esophagus.Presse Med. 2001 Jul 7-13;30(23):1148-50.

Leiomyomas of the lower third of the esophagus. Value of transhiatal enucleation.Ann Chir. 1994;48(5):446-51.

Leiomyoma of the esophagus.Thorac Cardiovasc Surg. 1986;34(3):194-5

Soft Tissue Pathology; Myxoid Tumours of Soft Tissue ;  Classification of Soft Tissue Tumour;  Gross examination of soft tissue specimen ;  A practical approach to histopathological reporting of soft tissue tumours ;  Grading of soft tissue tumours ; Lipomatous tumours ;Neural tumours ; Myogenic tumours ;Vascular tumours ;Fibroblastic/Myofibroblastic tumours ; Myofibroblastic tumours ;  Fibrohistiocytic tumours ; ChondroOsseous tumours ; Soft TissueTumours of Uncertain Differentiation ; Notochordal Tumour -Chordoma ;Extra-adrenal Paraganglioma.

AN APPROACH TO THE  REPORTING  OF ESOPHAGEAL BIOPSIES

BARRETT'S   ESOPHAGUS   (INTESTINAL METAPLASIA  DYSPLASIA  &   ADENOCARCINOMA)

BENIGN TUMOURS AND  TUMOUR - LIKE CONDITIONS  OF  ESOPHAGUS

 1. SQUAMOUS PAPILLOMA OF THE ESOPHAGUS

 2. INFLAMMATORY FIBROID POLYP OF THE ESOPHAGUS

 3. LEIOMYOMA OF THE ESOPHAGUS

 4. GRANULAR CELL TUMOUR OF THE ESOPHAGUS

 5. ESOPHAGEAL CYSTS

 6. GLYCOGENIC ACANTHOSIS

 7.FIBROVASCULAR POLYPS

REPORTING  OF  ESOPHAGEAL  RESECTION SPECIMENS

SQUAMOUS  EPITHELIAL  DYSPLASIA INCLUDING SQUAMOUS CELL CARCINOMA IN-SITU OF THE ESOPHAGUS

SMALL CELL CARCINOMA OF THE ESOPHAGUS

DRUG  RELATED  LESIONS  OF  THE GASTROINTESTINAL TRACT