Mucosal Schwann cell hamartomas do occur the gastric mucosa \u2013 report of two cases mimicking fundic gland polyps

Márcia Helena Oliveira Castro,Carlos Leonardo Martins Guimarães,Paulo Roberto Fontes Athanazio,Rodrigo Jose Felipe,Amanda Fernandes Cardoso,Daniel Abensur Athanazio

doi:10.1186/s42047-018-0026-3

Márcia Helena Oliveira Castro, Carlos Leonardo Martins Guimarães + Show 4 more

Open Access

https://doi.org/10.1186/s42047-018-0026-3

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Abstract

Mucosal Schwann cell hamartomas (MSCHs) are recently characterized benign spindle cell lesions of the colon and rectum. There is only one report of MSCHs in the stomach (antrum). Herein, we present the first reports of MSCHs occurring in the fundic mucosa as lesions that endoscopically mimicked a typical fundic gland polyp. Case 1. A 56-year-old woman sought medical attention due to epigastric pain. A small polypoid lesion in the fundic mucosa was removed with an endoscopic impression of a fundic gland polyp. Case 2. A 66-year-old man sought medical attention due to epigastric pain. The patient underwent antral and corporal biopsies that showed mild non-active gastritis without Helicobacter pylori infection. Small polypoid lesions in the fundic mucosa were seen; one was removed with an endoscopic impression of the fundic gland polyp. At the microscope, both lesions were entirely intramucosal, ill-defined spindle cell aggregations, suggesting a fascicular growth pattern. Both lesions were strongly and diffusely positive for S100. Awareness of this lesion is relevant to avoid the diagnosis of other benign spindle cell lesions that are associated with familial syndromes.

Highlights

Mucosal Schwann cell hamartomas (MSCHs) have been recently characterized as benign spindle cell lesions of the colon and rectum. These lesions are usually small and incidental findings upon colonoscopy. Awareness of this entity is important to avoid the diagnosis of certain similar lesions, such as mucosal neuromas and neurofibromas, associated with inherited familial syndromes that are associated with neoplasia (Davis and Berk 1973; Fuller and Williams 1991; Hochberg et al 1974; Lee and Norton 2000; Lewin et al 2005)
A small polypoid lesion in the fundic mucosa was removed with an endoscopic impression of the fundic gland polyp (Fig. 1)
MSCHs were described in a series of 26 cases in the colon and rectum by Gibson and Hornick; these 26 cases were compared to five submucosal neurofibromas from patients with known type 1 fibromatosis (Gibson and Hornick 2009)

Summary

Introduction

Introduction Mucosal Schwann cell hamartomas (MSCHs) have been recently characterized as benign spindle cell lesions of the colon and rectum. Awareness of this entity is important to avoid the diagnosis of certain similar lesions, such as mucosal neuromas and neurofibromas, associated with inherited familial syndromes that are associated with neoplasia (Davis and Berk 1973; Fuller and Williams 1991; Hochberg et al 1974; Lee and Norton 2000; Lewin et al 2005). * Correspondence: dathanazio@gmail.com 1Imagepat Laboratory, Rua Lucaia 209 - Edf. Eventus Empresarial, Rio Vermelho, Salvador 41940-660, Brazil 4Department of Pathology, Faculty of Medicine, Federal University of Bahia, Largo do Terreiro de Jesus s/n, Salvador, BA 40025010, Brazil Full list of author information is available at the end of the article fundic mucosa in lesions that endoscopically mimicked typical fundic gland polyps.

Results

Conclusion