{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:55:22Z","timestamp":1747187722206,"version":"3.40.5"},"reference-count":21,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T00:00:00Z","timestamp":1629849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pathology International"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Gastric mesenchymal tumors are relatively rare, and their molecular pathogeneses are poorly understood, except for gastrointestinal stromal tumor, desmoid, and inflammatory myofibroblastic tumors. We report a case of a gastric mesenchymal tumor with prominent smooth muscle cell differentiation and an echinoderm microtubule\u2010associated protein\u2010like 4<jats:italic>\u2010<\/jats:italic>anaplastic lymphoma kinase (EML4\u2010ALK) fusion. On gross section, the tumor was 26\u2009mm at the largest diameter, well\u2010circumscribed, and located in the submucosal and muscular layers of the stomach wall. Histologically, the tumor comprised intersecting fascicles of spindle cells, non\u2010atypical nuclei, and highly eosinophilic cytoplasm. Myxoid changes were observed focally, but inflammatory infiltrates were only evident in limited areas. Immunochemical staining revealed that the tumor was positive for \u03b1\u2010smooth muscle actin and desmin. Diffuse positive staining for h\u2010caldesmon was observed throughout the tumor, which suggested smooth muscle cell differentiation. Intracytoplasmic staining for ALK protein was also observed, and fluorescence <jats:italic>in situ<\/jats:italic> hybridization using <jats:italic>ALK<\/jats:italic> break\u2010apart probes showed split chromosomal signals. RNA\u2010sequencing analysis identified <jats:italic>EML4\u2010ALK<\/jats:italic> fusion transcripts. We concluded that the tumor was a gastric mesenchymal tumor with smooth muscle differentiation based on its distinct differential smooth muscle properties, such as highly eosinophilic cytoplasm and diffuse expression of h\u2010caldesmon. Furthermore, activated ALK may underly the tumor's pathogenesis.<\/jats:p>","DOI":"10.1111\/pin.13154","type":"journal-article","created":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T20:31:27Z","timestamp":1629923487000},"page":"707-711","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Gastric mesenchymal tumor with smooth muscle differentiation and echinoderm microtubule\u2010associated protein\u2010like 4\u2010anaplastic lymphoma kinase (EML4\u2010ALK) fusion"],"prefix":"10.1111","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1646-7505","authenticated-orcid":false,"given":"Eigo","family":"Akimoto","sequence":"first","affiliation":[{"name":"Department of Gastric Surgery National Cancer Center Hospital East  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masanori","family":"Tokunaga","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery Tokyo Medical and Dental University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reo","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Gastric Surgery National Cancer Center Hospital East  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiko","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Pathology National Cancer Center Hospital  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoichi","family":"Naito","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology National Cancer Center Hospital East  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riu","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Division of Translational Informatics, Exploratory Oncology Research and Clinical Trial Center National Cancer Center  Tokyo 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