Clinical and pathological analysis of 5 cases of calcifying fibrous tumor in gastrointestinal tract and literature review

doi:10.16150/j.1671-2870.2026.01.010

Abstract

Abstract:

Objective To investigate the pathological and immunohistochemical features, diagnosis, and key points of differential diagnosis of calcifying fibrous tumors (CFT) occurring in the gastrointestinal tract. Methods The clinical and pathological data of 5 consecutive patients with gastrointestinal CFT admitted to Huangshan People's Hospital from October 2023 to November 2024 were retrospectively collected. The clinical and pathological features of gastrointestinal CFT were analyzed by HE staining and immunohistochemical staining, and relevant literature was reviewed. Results Among the 5 patients, there were 2 males and 3 females, aged between 49 and 68 years old. Four cases with single lesion occurred in the gastric body (3 cases) and fundus (1 cases), and one case involved multiple masses in the gastric body, ileum, and pelvic abdominal wall. Microscopically, the tumors exhibited abundant hyalinized collagen fibers mixed with a small number of fibroblasts and blood vessels. The cells showed no atypia, and mitotic figures were rare. Three cases were accompanied by psammoma bodies or dystrophic calcifications. Immunohistochemical staining showed that tumor cells expressed Vimentin (5/5), SMA (2/5), CD34 (1/5), and CD117 (2/5), but no DOG-1, Desmin, and S-100. The Ki-67 proliferation index was approximately 1%. All 5 patients were followed up for 6-18 months, and no tumor recurrence or metastasis was observed. Conclusions Gastrointestinal CFT is a relatively rare benign tumor that needs to be differentiated from other mesenchymal tumors, such as gastrointestinal stromal tumors and inflammatory myofibroblastic tumors. Characteristic histomorphological features, such as hyaline degeneration and dystrophic calcification, are helpful for diagnosis.

Key words: Calcifying fibrous tumor, Histopathology, Gastrointestinal stromal tumors, Inflammatory myofibroblastic tumor

CLC Number:

TANG Ting, WANG Di, FANG Wei. Clinical and pathological analysis of 5 cases of calcifying fibrous tumor in gastrointestinal tract and literature review[J]. Journal of Diagnostics Concepts & Practice, 2026, 25(01): 71-77.

Figures/Tables 6

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References 22

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Case	Age (Year)	Gender	Location	Clinical manifestations	Gastroscopic findings	Imaging findings	Treatment methods
1	49	Female	Subserosa of gastric body, subserosa of small intestinal wall, abdominopelvic wall and mesentery	Nausea and discomfort	Not performed	CT: Oval soft tissue density mass under the serosa of the gastric fundus, with clear and smooth boundaries. On plain scan, the parenchymal density of the tumor was higher than that of the normal gastric wall, with atypical calcification in the tumor, and mild progressive enhancement on enhanced scan	Laparoscopic resection of gastric lesion, resection of ileal lesion and resection of intra-abdominal mass
2	54	Female	Gastric fundus	Discovered during physical examination	Submucosal protrusion with smooth surface mucosa, accompanied by hyperemia and focal erosion	CT: No abnormality reported	Endoscopic submucosal dissection
3	68	Male	Gastric body	Discovered during physical examination	Submucosal protrusion with smooth surface mucosa	CT: Uniform enhancement after enhanced scan	Endoscopic submucosal dissection
4	53	Male	Gastric body	Discovered during physical examination	Submucosal protrusion with hyperemia, macular appearance and focal erosion	CT: No abnormality reported	Endoscopic submucosal dissection
5	68	Female	Gastric body	Upper abdominal pain accompanied by nausea and vomiting	Submucosal protrusion with smooth surface mucosa	CT: Mild enhancement after enhanced scan	Endoscopic full-thickness resection

Case	Disease location	Solitary / Multiple	Size（cm）	Gross	Pathological morphology	Psammoma bodies	"Cuff-like" structure	Immunophenotype
1	Subserosa of gastric body, subserosa of small intestinal wall, abdominopelvic wall and mesentery	Multiple	1.1-2.0	Well-circumscribed, grayish-white cut surface, firm or hard consistency	Hyaline degeneration of collagen fibers with a small amount of non-atypical fibroblasts	Present	Present	CD34 （partially+），CD117（partially+），DOG-1（-），S-100（-），SMA（partially+），Desmin（-）
2	Submucosa of gastric fundus	Solitary	0.8	Well-circumscribed, grayish-white cut surface, hard consistency	Hyaline degeneration of collagen fibers with a small amount of non-atypical fibroblasts	Absent	Absent	CD34（-），CD117（-），DOG-1（-），S-100 （-），SMA（-），Desmin（-）
3	Submucosa of gastric body	Solitary	1.0	Well-circumscribed, grayish-white cut surface, hard consistency	Hyaline degeneration of collagen fibers with a small amount of non-atypical fibroblasts	Absent	Absent	CD117（-），CD34（-），Desmin（-），DOG-1（-）， SMA（-），S-100（-）
4	Submucosa of gastric body	Solitary	1.7	Well-circumscribed, grayish-white cut surface, moderate consistency	Hyaline degeneration of collagen fibers with a small amount of non-atypical fibroblasts	Present	Present	CD117（-），DOG-1（-），CD34（-），Desmin（-）， SMA（-），S-100（-）
5	Submucosa of gastric body	Solitary	1.7	Well-circumscribed, grayish-white cut surface, moderate consistency	Hyaline degeneration of collagen fibers with a small amount of non-atypical fibroblasts	Present	Present	CD34（-），CD117(scattered+)，DOG-1（-），Desmin（-），S-100（-），SMA（+）