A Case of Gastric Leiomyoma Presenting Bilirubin Formation in the Tumor

Hiroshi Hashimoto, Kojin Endo, Junichi Mikuni, Yoichiro Kakugawa, Yasuhiko Kamiyama, Tsuneaki Fujiya, Hidemaro Ono, Tohoru Sugawara, Kiyoaki Ouchi

Department of Surgery, Miyagi Cancer Center

A 70-year-old woman was diagnosed as having a gastric submucosal tumor with a diameter of 6×4 cm in the cardia of the stomach. The histological diagnosis of gastric leiomyoma was made following proximal gastrectomy. Histological examination revealed yellow pigment in the resected tumor, with calcification. The pigment was determined as bilirubin by positive Schmorl and Hall reactions. In addition, hemosiderin pigment, which was stained with Berlin blue, and numerous macrophages were found in the tumor. It can be said that bilirubin may be formed from hemoglobin in intra-tumor hemorrhage with macrophage-related phagocytosis, because there was no connection of the biliary system with the tumor and no ulcer in the gastric mucosa.

Key words
bilirubin formation in tumor, gastric leiomyoma, macrophage

Reprint requests
Hiroshi Hashimoto Medical Section, Camp Funaoka, Ground Self Diffense Force
1-1 Oonumahata, Funaoka, Shibata-cho, Shibata-gun, Miyagi, 989-16 JAPAN

Accepted
July 2, 1997

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